Loving Kindness Meditation for Self Care

In the yoga and mindfulness world, there is a particular type of meditation referred to as “Loving Kindness,” or “Metta.”

It is a mediation practice that is rooted in compassion and love, and is usually guided by a script.  It asks you to send intentions of peace, safety, health, and love toward an individual, a group of people, or the entire human race or the universe.

 It is a wonderful practice that I have begun to implement into my own personal life, as well as into my work with caregivers. Part of why this resonates with me and the people I work with, is because this type of meditation taps into the light that we each have within, and sends that light and compassion out into the world.

This is something that as caregivers, we all intimately know.  It taps into the warmth and light that we know can be so nourishing and necessary in this world when we activate that towards others. But what about activating that towars ourselves?

In our work with self care, I like to start with visualizing a person you are caring for. (Keep in mind that if you care for multiple people, the first person who comes to mind is usually the exact person who should. )

As you visualize this person, repeat the following intentions silently to yourself with your eyes closed:

May you be free from inner and outer harm and danger.

May you be safe and protected.

May you be free of mental suffering or distress.

May you be happy.

May you be free of physical pain and suffering.

May you be healthy and strong.

May you be able to live in this world happily, peacefully, joyfully, with ease.

Next, think of a person whom you is very dear to you. It might be a family member, it may be your child, or a grandparent figure. Who is it that comes to mind when you think of love and warmth and closeness? The first person who appears to you is usually the perfect one.

As you visualize this person, send the intentions silently:

May you be free from inner and outer harm and danger.

May you be safe and protected.

May you be free of mental suffering or distress.

May you be happy.

May you be free of physical pain and suffering.

May you be healthy and strong.

May you be able to live in this world happily, peacefully, joyfully, with ease.

For the last phase, I want you to hold onto those feelings and now visualize yourself. Speak directly to your own heart as you send those same, loving intentions to yourself.

May I be free from inner and outer harm and danger.

May I be safe and protected.

May I be free of mental suffering or distress.

May I be happy.

May I be free of physical pain and suffering.

May I be healthy and strong.

May I be able to live in this world happily, peacefully, joyfully, with ease.

Sit with that for a few minutes, and see how you feel. Afterward, it is interesting to ask yourself:

-        How was that last set of intentions?

-          Was it easier for you to send love and light to another person you love than it was to send that same wish for love to yourself?

If the answer is yes, you are not alone.

For so many of us, especially women, we have no problem seeing others as being worthy and deserving of safety, health, and love. We sacrifice our own well-being if it means making sure someone else feels that sense of safety and love. Yet, when it comes to ourselves, this concept may even feel foreign.

Traditionally, this meditation is done by sending the intention to yourself first, followed by expanding the intention outward to specific individuals, and ultimately to the universe.

But in a self care practice, I find that focusing on someone who is dear to you first activates those feelings of compassion that caregivers easily access toward others, making it a bit easier and perhaps more powerful when we shift that light onto ourselves.

To all of you caregivers, who give tirelessly day-in and day-out, consider taking a few moments today to spread some loving kindness to yourself.

If you are interested in reading more about loving kindness meditation, "Loving Kindness: The Revolutionary Art of Happiness," By Sharon Salzberg is highly recommended!

Random Acts of Kindness as Part of Your Self Care

It's funny how sometimes you notice themes that keep popping up in your life. For me, over the past few weeks I have read about, seen, and experienced random acts of kindness happening, and it got me thinking.

One of these things was a a "random acts of kindness" challenge posted by many friends on Facebook. The post says to leave a comment with "I'm in," and the person who posted the comment will randomly send you a gift or do something nice for you in the upcoming weeks- the only request is that you also post the challenge and pay it forward to others.

Then yesterday, as I was listening to one of my favorite talk radio shows, the woman featured on the program began speaking of a recent study that came out about the correlation between performing random acts of kindness, and boosts in self esteem of the person who performs the acts. At the heart of the study is the confirmation that we gain pleasure and feel better about ourselves when we know that we have helped others.

Now I didn't necessarily need to hear the results of a formal study to confirm this for me. I generally feel a deep calling to spend my life in ways that will positively impact others- but the fact that lately this theme of random acts of kindness keeps coming up for me, got me thinking about random acts of kindness as part of self care.

So I want to share some of my favorite RAOK with you, and see if you would share some of yours.

One of my favorites is leaving a dollar with a sticky note on it in a magazine in a waiting room of a dentist or doctor's office, or somewhere people may be waiting with anxiety or fear. On the sticky note, I write a short little note, something like, "This is meant for you, please take it and have a wonderful day!" The note makes it known to the person that it is there to take, that someone left it on purpose, and they were the lucky one to find it. Its such a small act, but it could really make someone's day.

Another favorite, is to send a text to someone who may come to mind, someone you know is going through a difficult time, or maybe even someone you haven't spoken to in a long time. Send them a text that says, "Thinking about you and sending love," or something simple to that effect.  You would be amazed how many times the person will write back, thanking you and exclaiming how much they needed to hear that in that moment.

I tend to go to a lot of events for my job. I find that when it is an event that has a catering staff, seeking out one of the servers at the end of the night to thank them for their wonderful service solicits the most surprised and grateful responses. Caterers are trained to work under the radar, so as not to distract guests from the speakers or performances going on during the meal. The servers are often ignored or treated rudely, and rarely are they thanked by the guests- because honestly the best ones are the ones you hardly notice. So a simple acknowledgement of how hard they worked that night, a simple thank you, and an acknowledgement of their existence and service can go such a long way! I never regret the extra minute it takes at the end of the night to find someone to say this to.

One story that the woman on the radio program shared, had a similar theme. She spoke about how one day at the check out line in the grocery store, she looked up at the cashier and noticed that she was elderly. She said to her, "It must be so hard to have to stand all day." And the woman's eyes actually filled with tears, and she said, "Thank yo so much for saying that. I really need this job to pay my bills, but I am getting older and it is very hard for me to be on my feet for a whole shift. Some days I don't know how I will make it through, but I have never had anyone notice before. Thank you." That moment of connection made both women feel validated and just a little bit better.

Even though the point of these acts is to make others feel better, the truth is, they make the giver feel good. (After all, isn't that why many of us choose to be caregivers in the first place?!) The next time you find yourself having a difficult day, or overwhelmed by your responsibilities as a caregiver, try out one of these simple random acts of kindness- even if you feel like you have nothing left to give- and I think you will be pleasantly surprised at the positive impact it has on your mood, your self esteem, and your feeling of connection with the good in the world.

Leave a comment and share some of your favorite random acts of kindness!

The Importance of Rituals in Self Care

I recently attended a workshop by the amazing and inspiring author, Thomas Moore. He was speaking in relation to his newest book "A Religion of One's Own: a guide to creating a personal spirituality in a secular world."  Even though he spoke about his purposeful decision to use the word 'religion' in the title, I found myself wishing he had not done so, because the use of 'religion' may turn people off who might otherwise enjoy and connect with his message.

Moore's major point in the book is that we can all create our own "spiritual practice," whatever that may look like. His central theme was that we can individually create practices that speak to our heart, and help us find balance and peace, emotionally and spiritually. For me, I understand this in a context of creating self care rituals.

A part of making this work for you is finding rituals that you can incorporate into your practical life. Rituals can be part of the traditional religious experience, such as attending church or participating in the formal sacraments, as in the Catholic tradition. But more importantly, they can be really ANYTHING that nurtures you and your heart, and helps you find connection and balance.

Rituals can be daily, weekly, annual, or once-in-awhile activities. If it speaks to you, if it forms connections with others or your surroundings, and gives you peace, it should be considered part of your self care rituals. Something as simple as meeting a friend for coffee at your favorite coffee shop once a month can be a ritual that nurtures you. It could be attending an annual baseball game with family or friends.

I know for me, when I enter Fenway Park, I feel energized and excited in a way that not many other places make me feel. That park is a sacred place to me, and attending an annual game with people I love is one of my most valued rituals, and I consider it part of my self care.

For many people, sports-related activities have a true ritualistic nature. Think about the guys and girls that get together every Sunday for food and football. Or others who meet up on the golf course. It is a communal gathering that has traditions and rules, and can ignite a spark inside us that we may rarely find in other activities.

 A daily ritual for  me is attending yoga class after work. For me, knowing that I will be able to attend a class that will nurture my body and mind, helps me get through the day-- even when it has been full of draining tasks.  Attending this ritual also helps me to transition from work to home life. It allows me permission to observe myself without judgement, and helps me to let go of feelings of guilt or sorrow that I could not have done more to help someone that day. When I leave that yoga class, I feel more centered and am less harsh on myself for the things I wish I could have done better that day.  I leave it there, and am able to be more present for the rest of my evening.

Having a morning ritual is a wonderful way to start your day. It doesn't have to be intricate or take a lot of time, either. A friend of mine describes her morning ritual as taking the few minutes when she is waiting for her tea water to boil, to sit in silence and just breathe. When the tea kettle begins to whistle, she pours her tea and drinks that in silence while she reads the newspaper. This is very simple, but for her, having that consistent start to her day, can make all the difference.

Connecting with nature can also be a part of your rituals. Hiking a certain path through the woods, or walking down the beach are forms of self care rituals. Incorporating mindfulness into your time with nature can also help you find peace and grounding, and appreciation of the beauty all around us, even on days when your world may feel harsh and small.

Growing up, my siblings and father and I would hike a local hill called Lantern Hill every Columbus Day weekend.  Looking back, I realize this was a special ritual that we shared. It was the time of year when the leaves had changed to the bright golds, reds, and yellows of a New England fall. We would hike to the top and look out, taking in the beauty of the New England foliage all around us. For me it was a bittersweet ritual about taking in nature's beauty, but also saying good-bye to the leaves that were about to fall, and preparing for the transition to winter. For someone who does not enjoy the cold dark winter season, there was something very comforting about knowing that we would be back to do it again next year.

What do your rituals look like? You may already be doing some of these things, but never thought about it in this context of self care rituals.  Are there more things that you can purposefully engage in on a regular basis to improve your self care?  Take a few minutes to think about one ritual you can add to your repertoire, or one you can continue doing in a purposeful way to help take care of you.

Creating a 'Practical Mindfulness Practice'

As caregivers, the central theme that we all share is that we put others' needs before our own-- which is the main reason why purposefully choosing to engage in self care is so important for all of us. 

When we embrace the role of a caregiver- whether it be as a part of a profession or part of a role as family member or friend- we commit to giving of ourselves. We may give our emotional support, our spiritual support, or we may need to literally give of our physical strength to hold someone up, to carry them, or to restrain them from hurting themselves or others.  All of these forms of giving take a toll on our own spiritual, emotional, and physical well-being.  And on top of that, take up A LOT of our time.

This is why it can be so difficult for so many of us to envision how we can possibly make time to take care of ourselves throughout our busy days.  My message to you today is this: it IS possible to practice small acts of self care. It is just about figuring out how to fit it into your daily life, in a practical way. You CAN create your own "practical practice." I recommend starting with a mindfulness practice.

While there are many definitions of mindfulness, my favorite is from the mindfulness expert, Jon Kabat Zinn. He describes mindfulness as, "paying attention in a particular way, on purpose, in the present moment, and non-judgmentally." 

If you are not familiar with the practice, I suggest searching YouTube for guided meditations by Jon Kabat Zinn or Thích Nhất Hạnh. These are two amazing mentors who will guide you through the basics of the practice. 

Mindfulness asks you to slow down, to pay attention to your breath, and to observe yourself without judgment.   For caregivers, who feel like we barely have time to think about anything else but the needs of others, it may sound daunting, or even impossible, to find the time to meditate or practice mindfulness. BUT- the best part of mindfulness, is that you can practice it pretty much anytime and anywhere.

Once you have a general understanding of mindfulness, and have practiced it a little bit, you will find that you can practice mindfulness in walking, eating, even in sitting at a red light, or answering a ringing phone.  Thích Nhất Hạnh suggests using a red light like a meditation bell. Instead of being frustrated that the light is stopping you from getting where you are going, you can learn to actually love the red light in this moment (this may sound impossible, I know!). 

When you begin to look at the world through a lens of observation and awareness, it will become possible for you to make the shift from wanting to curse the red light, to thanking that red light for giving you the opportunity to stop for a moment. In this new awareness, you may look at the light as the universe giving you permission to slow down, even for just a few seconds. The light is giving you the opportunity to take some time to nourish your body and mind with your breath, to become present, and to clear your mind of any judgmental thoughts that are not serving you. You may find that when the light turns green, you feel a little more calm and centered, instead of more stressed and frustrated.

Another practical way to introduce mindfulness into your busy day, is to use the ringing of the phone. The sound of a phone ringing can often be stress-inducing for caregivers, especially if you are caring for a loved one who is ill, or if you are on-call for crisis situations at work. The sound of that ringing can trigger anxiety and dread for what bad news may be at the other end of the call. The challenge here, is to use that ringing, similar to the red light, as a signal to slow down, to take some breaths, and to become present in the current moment.  

In the Buddhist tradition, it is recommended that we build a mindfulness community with people who can share and encourage your practice. So for this phone exercise, have a conversation with the community of people who may be calling you with caregiving-related news. Make an agreement that at both ends of the phone call, you will each take three rings to breath deeply and become present before the conversation begins.  In those few moments, when you are both separated but listening to the same ringing, you become connected in mindfulness practice. 

Then, when you do pick up the phone, the conversation will come from a place of presence and non-judgment that otherwise may not have been possible. Even if there is difficult news to hear on the other end of that ringing, the connection and presence you bring to the moment will allow you to respond with compassion instead of react out of fear. 

This shift can be powerful on a physical and emotional level. Shifting from responding out of presence and compassion, instead of reacting from fear and anxiety, can protect our hearts and nervous systems from the rush of adrenaline that comes from anticipating the worst. Any time that we can reduce the body's fight or flight response, by changing stress triggers into mindfulness reminders, we reduce physical levels of stress in our bodies.  In doing this, we are performing small acts of self love that will help us sustain our emotional, spiritual, and physical well-being, so that we can show up as our best selves for those we are caring for.

"When you love someone, the best thing you can offer is your presence. How can you love if you are not there"

          - Thích Nhất Hạnh

Happy Practicing!

For your Own Safety

On my recent flight back from Haiti, I found myself tuning out the flight attendant's "in case of an emergency" speech before take-off. But the speech came back to my attention when I heard the familiar line, "For your own safety, be sure to secure your own oxygen mask before securing that of the person sitting next to you."

"Self care." I thought.

The analogy is simple. Airlines asks that passengers  (especially mothers traveling with children) secure their own oxygen before they assist the person sitting next to them, so that they will have the oxygen necessary to sustain them through helping their neighbor. If mothers were to tend to their children and ignore their own needs, there is a good chance that the mothers would suffocate before they could help their child, and neither party would have a chance.

Following those instructions seems to make sense logically, but think about how difficult it would really be in that moment to take the time to save yourself when you know your child is suffering right in front of you. Would you really be able to make the choice to help yourself? It takes a conscious decision to do what's best in the long term, so that you both can survive.

This is completely relevant to self care. It is easy to put the needs of the people you are taking care of above your own. You give so much of your limited time and energy to your caregiving role, that sometimes when you stop and look around, you can't breathe.

Women, especially, have a difficult time putting their own needs before others. We feel guilty, or we don't think there is enough time in the day to set aside time for ourselves. But if you think about it in terms of the flight attendant's instructions, taking care of yourself is not only recommended, its required.

If it is important enough for airlines to remind travelers on every flight about the policy, and it is the training that they requires all employees follow, then there must be something to it, right?

The take away point is this: If you feel guilty about taking time out to do something for yourself-- to ground yourself, to release stress, recharge your batteries, or recenter your spirit-- then don't.

I know this is easier said than done, but the truth is, it is the only way that we will survive in the long run. It is the only chance we have at being present, compassionate, effective caregivers for any measurable amount of time. Without making self care a priority that we accept as general policy in our lives, there is a good chance we will damage ourselves to the point of having no chance to help anyone else, because we can't breathe.

Summer Rejuvenation

Summer (especially in New England) is the best time of year for self care in my opinion. Here are some of my favorite self care activities for the summer months.:

- Gardening
Spring and summer are wonderful times to utilize gardening as a self care tool. Taking care of something other than the people you are caring for, can be soothing, healing even. If you are a caregiver, then nurturing is in your nature. Tending to flowers provides a satisfying outlet where you can nurture something in to life and bloom, without some of the major stressors you may find in your work caring for human beings.  The best part about flowers is that they respond to your care, and the don't talk back to you! There is no complaining, there is no suffering to face and sit with (unless you slack off in your watering duties perhaps :-).

Because gardening produces a beautiful, tangible outcome that is both soothing to surround yourself with, and satisfying in a way that caring for others may not be.  One of the most draining parts of caring for others for me, tends to be the frustration in not seeing tangible results. Especially in the mental health field, progress can be so very slow, and digression is all too common. So for me, there is something about nurturing living plants that yield tangible results in the form of beautiful flowers, that sooths me.

I acknowledge that to all people who consider themselves to have green thumbs, and the thought of having another responsibility, such as watering plants, is just about enough to send you into panic. But if you make it part of your after work, self care routine, I find it is a great way to detach from the days caregiving stress, to take some quiet time for myself, and to stimulate my senses by feeling the sun and the water, by smelling the scents and viewing the vibrant colors. It is rejuvenating and recharging.

- Photography
One of my favorite creative outlets for self care has become photography. Similar to gardening, it is something  with a tangible outcome that I can surround myself with. Summer offers a beautiful time of year to photograph summer scenery. Taking pictures of the flowers in my gardens has enabled me to combine two of my self care outlets.  My living room has become my "photo gallery," so that I have been able to further surround myself with beauty that I have played a part in making.  I find scenery photography soothing and centering. It also is a great tool to surround yourself with pictures of loved ones and moments of connections and laughter. remembering our connections to those who love and care for us cannot be underestimated.

- A Great View
There is something incredibly soothing about sitting in front of a view that is far reaching, especially one with a vantage point. When I am feeling particularly overwhelmed, I go to my favorite local beach, that looks out toward a lighthouse on the horizon. There has been research done that suggests that this type of view with a vantage point in the distance is stress reducing and can promote clarity. The view doesn't have to be of the beach. It could be a meadow, or a lake, or the view from a hill. Think about where you live. Where is there a good view with a vantage point? Take some time to hike that hill, or walk out to that beach, or to drive out to that straight away. take some time to stop, and sit, and breathe. If you meditate this would be a great place to do that.

How do you take advantage of the summer months to rejuvenate yourself?

Self Care & Limit Setting- Protecting your Energy and Spirit

Self Care & Limit-Setting: no one is going to do this for you, and it requires work! 

Limit setting can be especially difficult for caregivers due to the simple fact that we are in this work because we want to give of ourselves, because we have the ability to put ourselves second (or third or fourth) so that others can come first. So, when we speak about setting limits, saying no, or looking out for ourselves, it tends to be an uncomfortable or foreign concept for helpers to grasp.  Along with wanting to give, caregivers tend to have a strong need to be needed. We pride ourselves on the fact that we can take care of people who need help taking care of themselves, that we can hold things together for other people when they are losing their grasp,

The challenge for caregivers is to have the self awareness to be able to identify what the important limits are for each of us, and to actively work to maintain and communicate those limits so that  we can ultimately be as present as possible when we are engaged, and we may actively disengage when we need to. This takes a conscious commitment to yourself to first get to know yourself and what you need, and second, to take action steps for setting limits in order to protect your mind, heart, and spirit. In a day where we are all connected on an unprecedented level through our smartphones, it takes a conscious effort to turn it off, to say no, to put it down, to get away. The attention paid to the realistic limits of a human being surrounded by suffering on a daily basis can make or break a life of care-giving.

Who would have thought that in order to reduce stress and workload that we would need to actively work at things like setting limits? But it is true; and without making that effort, it is easy to look up and find yourself facing an unrealistic workload with nothing left to give.  Setting limits is what enables us to save our energy, our spirit, and to protect our hearts.  In a field where you are asked to constantly give of your mind and heart, it has to be okay to say "I just can't right now."  It has to be okay to delegate a task, to say no to an extra assignment, to ask to continue a conversation tomorrow, or to leave work on time (and not feel a b--ch for doing so!). Without setting limits, saying no, and setting aside time for ourselves, we cannot maintain our own emotional and spiritual balance that we desperately need in order to be effective caregivers.

If you find yourself struggling to maintain your energy and emotional balance, perhaps it is worth examining your limit-setting practices.  The ability and willingness to actively set limits for yourself can be enough to make or break your career or lifestyle as a caregiver.

Here are some questions to consider to measure how well you are setting limits for yourself:

- How many hours per week are you required to work? How many hours per week do you actually work?


- Are you required to be on-call for work? Do you receive work-related calls when you are not on-    call?


- Does the work you are doing (beyond that of the hours required of you) have to be done then, or can   it wait?


- Do you have a hard time saying no to requests, even if the task does not fall under your job description?


- Do people come to you to fix things that you didn't "break"? Do you always attempt to fix them?


-Do you leave work feeling like the energy has been sucked out of you? What specific tasks or interactions make you feel this way?

Next, you may want to consider what you can actively do to improve your limit-setting:

-Is there a theme or pattern about what I find draining?


-Where can I set firmer limits? 


- Where can I communicate my needs regarding these limits so that the people around me understand what my limits are?


-What goal or action steps can I plan for setting better limits?

Over the years I have identified some key limits or boundaries that I need to communicate and maintain in order to protect my energy (and sanity).


Here are some examples of limits that are important to me: 

- I do not take calls from work when I am not on-call. 

Seems pretty common-sensical, however I have had to actively work at conveying that request to my supervisor and my staff. There is an on-call system in place where I work so that there is always someone available by phone. I have had to make it very clear that when my name is not on the schedule, I am NOT available for calls.  I do this not to be rude or disconnected, or because I don't care. I actually do it because I care too much, and would never be able to completely separate myself from work if I allowed staff to call my cell phone whenever they have a question.  I would never have a day to myself where I don't have to worry about work, which results in me returning from my days "off" no more fresh and energized than I was at the end of last week.  I have had no time to rejuvenate and recharge.  I have realized that I need to "emotionally reboot" after five days at work or I cannot be a good caregiver.

- I only entertain complaints and staff issues during supervisions or in writing.
 I have asked my staff to please not approach me with a complaint whenever they can catch my ear. Instead, I have asked that complaints should be put into writing and submitted to my mailbox, or brought up during regularly scheduled supervisions. I will then schedule an appointment to discuss the issue that has been reported.  Again, this is not to be dismissive, or rude, or to seem distant to the needs of my staff, but it is my effort at protecting my own positive energy. I am someone who feeds off of and is very aware of the energy of those around me, be it positive or negative.  I have found that in order for me to be effective at managing complaints or staff upset, I have to be in the right mental space to do so.  If I can manage when I am dealing with intense negative feelings from staff and be prepared to do so, then ultimately I will be more present and effective in moving forward, in supporting my staff, and for making positive change.

- I leave when my shift is over.
This one may not sound like rocket science, but it is extremely important for me to leave after I have been here for 8 hours. In a home that is open and operating 24 hours a day, seven days a week, it would be VERY easy to spend upwards of 60 hours per week at work.  On days where it feels like there is so much to do that we are never going to get it all done, I have found it to be more detrimental to my long-term emotional well- being to stay at work longer than 8 hours. I have tried working four ten hour days, and learned that for me, eighth hours is my limit if I still want to be effective.

For different people this may be different. But through my self awareness work, I have come to realize that I am going to be more productive, helpful, and effective if I stop when its time to go- and go! The work will still be there tomorrow, I will be more rested and productive in the morning, and if I stay too long today I am setting myself up to be burned out by the end of the week. Sometimes we are so used to being needed that its almost a let-down if I actually can get up and go home, and no one thinks we should stay. Thoughts like, "Doesn't anyone need me right now?" "So if I go, things will just go on, you mean no one may even notice!?" "There's no way this place can run without me." We have to fight our inner needy caregiver to allow us to take a break or call it a day for the sake of our own sanity!

These three limit statements may come across as harsh, and I have definitely had to work towards having my supervisor and colleagues understand and respect these requests. But the result of me communicating these needs is that I am able to be more present when I am here, and  I am able to sustain my positive energy better and longer than I would be able to if these requests and limits were not honored.  Sometimes in order to look out for others, we need to look out for ourselves first- because as psychiatrist Dr. Wayne Dyer says,
"You can't give what you don't have."

So, how are your limit-setting skills? Where could you improve in setting and communicating those limits?

Staff Care: a New Spin on Team Building

In the care-giving professions,  employees are asked (expected even) to focus nearly all of our energy, spirit, and time solely on the needs of our clients/patients.  The expectation is that we make them our priority,  that we be empathetic and attuned to them, to be with them in their most dire time of need.  And in doing so, the expectation becomes to put our own needs aside while doing so.

While I do not disagree that clients and patients should be the central focus of our time and energy, and that they deserve that treatment, my deep concern lies in how to sustain the type of  healthy, emotionally regulated staff that will ultimately be able to provide the best care to our deserving clients.  In the agency where I work, we act under the assumption that "kids act better when they feel better." This is the premise for much of the trauma-informed care approach that is sweeping the nation in behavioral health and in working with trauma survivors. I suggest that we apply the same concept to staff- that staff will act better when they feel better.

Over the last six years I have watched the staff  who are charged with working with the sometimes very difficult  population- adolescent girls with trauma histories. I have been amazed at how far they are willing to go for our kids. They are willing to put themselves in harms way at times, to sit with children as they rage and scream and sob, to come in each day with a smile and with hope that today will be the day they will plant a seed that will make a difference in our girls' lives.

I also watch (and experience) the days where our caregivers walk in the door looking drained, exhausted from last night's crisis, on the verge of tears at times, less open to the kids, and with less patience than may be characteristic.  So I ask myself,  what is different on these days? What makes it easier to come in to work with that hope and that smile and that motivation to make an impact? What makes it more difficult to do this? What can organizations do in order to help their staff have more of those "good days"? Is there a role for administration here? Is it just a occupational hazard that is unavoidable? Or is there a better way?

The major reasoning for the change in the therapeutic approach from a more traditional, punitive one to a strength-based model, was that the traditional approach did not motivate the kids to do better. Why?  Because most of these kids want to do better (regardless of the amount of rewards and punishments associated with their behavior), they just don't have the skills, or the self awareness to choose a better option. I would argue that this is the same for care-giving staff. Without the proper training, self awareness, and the support, it will be more difficult for caregivers to choose the most empathetic, most attuned, and effective approach with the clients.

So what can we do to get our caregivers there?  I think there can be some simple solutions here, but one that takes commitment from the top, (and maybe even a place within the organization's strategic plan). I believe that a commitment to staff care will go a long way in helping to create and sustain the type of quality, genuine care givers that our clients so desparately need.

So what constitutes staff care? Some of it is cultural, and a lot of it is about gratitude and appreciation for each other. To create a culture of compassion and gratitude between coworkers can take time, and is mainly going to need a leader who walks that walk. But there can be simple, concrete activities, and gestures that can go a long way with staff.  One suggestion is to have a "Staff Care" day once a month or every few months. This is similar to a team building staff meeting, and has similar goals, however with a slightly different spin. (I find that when people hear that phrase they begin to feel unsafe. I here comments like, "Are we going to have to get up out of our chairs? "Are we going to have to play corny games?" "Is this going to be you guys trying force us to have fun?"  It kind of makes me laugh, but these are true fears and anxieties that are brought up for people when they hear the words "team building.")

My suggestion is this: Turn your regularly scheduled staff meeting into a kind of "Staff Appreciation Day" or "Honoring our Caregivers Day." Last week we tried this with our staff.  My goals were as follows:

- To create a sense a team while minimizing anxiety around "team building activities"

- To acknowledge and honor the difficult work that our direct care staff perform day in and day out, and to allow them time to celebrate the gains, and to grieve the losses we endure.

- To create a sense of community and compassion amongst our caregivers, and sense that "we are in this together."

So, the two hour meeting consisted of the following activities:
1. We opened with an exercise in gratitude towards each other. This was a simple activity that requires minimal prep, you simply need a piece of paper for each person with their name across the top. Post these pages around the room on the walls, and provide markers. As people stream into the meeting, amidst casual conversation staff members are asked to mingle through the room and write something they are thankful for on each staff person's page. It could be a direct thank you for something they have done, or a reminder of a strength that they bring with them to their work that you would like to acknowledge.  Leave the pages posted throughout the meeting and at the end each person takes theirs to go. This serves both as an opener and as a reflection piece for people to take with them after the meeting has ended. It also emphasizes a strength-based approach and helps with staff's self worth and sense of being an effective team member.

2. We played a slide show of the highlights of our program over the past year.  We paid tribute to the good times, laughed about the funny times, and even teared up when remembering some difficult ones.  We decided to do this over lunch, as it created an easy-going laid back atmosphere that sparked discussion when the slideshow was over.  The two hours that it took me to find and put together the pictures was well worth the result, and the staff thanked me for taking the time to honor their work and remind them of all of the good work that we have been doing.

3. We created "Self Soothing Kits"- FOR THE STAFF! "Self-Soothing Kits," also referred to as "Comfort Kits," or "Sensory Kits," is a technique we use with our kids to help them identify what types of things help them calm down, or feel soothed when they are feeling stressed.  It is about engaging all of the senses with stimulus that is soothing, calming, and grounding in the moment.  We provided an assortment of the following materials: (sample-sized) lotions, candles, shampoos, bubble bath, bubbles, candies, pieces of fabrics, inspirational quotes, scenery (cut from magazines) of gardens, beaches, and serene landscapes. We scattered these items across the table and told the staff to go at it! We instructed them to pick items that appeal to them and that would help to sooth them when they are feeling stressed.  Once the staff members realized the goodies were for them, and we weren't making these for the residents, their eyes lit up and they excitedly began to rummage through the supplies.  As we constructed our kits, we listened to my "Superwomen" playlist, where I had compiled songs that celebrate the strength of women, particularly caregivers, such as Alicia Keys, "Superwoman."  We began a discussion about what our self soothing kits at home could consist of, and recommendations for stress-relieving activities that staff already practice on their own. The vibe was relaxed and the discussion was easy-going, light, supportive, and full of glimmers of self-awareness that made me smile.

4. Our last activity was a guided imagery session based on the Dali Lama's recommendations for a daily mindfulness practice.  As I played some yoga music and dimmed the lights, I slowly took the group through an inward journey of breath and acceptance that involved focusing on observing ourselves without judgement, cherishing ourselves, cherishing others, and especially cherishing those who we may find it difficult to cherish. At the end of the five minute exercise,we raised the lights and allowed for comments and discussion. The feeling of the group was one of  peacefulness, compassion, and acceptance- even between staff members who would probably consider each other "difficult to cherish."

5. We closed by having each person pick and read out aloud one of Dr. Wayne Dyer's cards for Success and Inner Peace. The staff found it interesting who chose what cards to read, and we each reflected on what they meant to us individually and related to our work.  Before everyone got up to leave, we thanked staff for their commitment to our program and to our kids, and reminded them to take their gratitude pages with them on the way out.

The feedback over the next few days was extremely positive and grateful, and I couldn't help but notice the women on our team taking better care of each other and of our kids in the weeks to follow.  The power of gratitude, appreciation, and honoring the work that caregivers are choosing to do continues to amaze me, and I believe there is a direct relation between how well we take care of each other and how well we take care of our clients. Here's to the superwomen!

Finding Balance Amongst Your Diverse Roles

I have recently been struggling with keeping balance between the different roles I have in my life.  I am committed to being there for different people in a variety of ways, and yet often weeks go by in which I may spend 75% of my time (or of my productive time) dedicated to one of those roles.  What does this look like?

When I step back and think about all of the roles that I fill, and all of the relationships that I want to nurture in my life, it can become overwhelming.  So my suggestion is to start with identifying what those are for you. What types of relationships am I truly committed to, and what types of roles do I play in those- what are your "Role Goals"?

Personally my "role goals" are as follows (in no particular order):
An emotionally and physically healthy woman
A fun, reliable friend
A supportive supervisor
A compassionate caregiver
A contributing board member
A  connected family member

So after listening to some advice from the MA Women's Conference, I have begun looking at those roles, and making an effort to find balance amongst them.  It was suggested that you make a weekly "To Do List" of anything that you can possibly think of that you need to accomplish in the week to follow. Sometimes the simple task of getting it all down on paper and out of your head is stress-relieving.  But I would recommend taking it a step further by mapping out your To Do Items under their appropriate role. After delegating all of your tasks, step back and take a look at what roles are unbalanced, overworked, or ignored even. It may sound tedious or difficult, but I have been pleasantly surprised by the results.

It would be very easy for me to sit down and make my "To Do" list for the week, and have it be 85% work-related.  And if that is the case, then I am most likely going to be addressing two of my roles (supportive supervisor, and compassionate caregiver), but the other roles fall by the wayside. In fact, in ignoring my other roles I may actually be setting myself up to work against those other roles.  For instance, if my To Do List is filled with work related tasks, then most likely my physical and emotional health will take a toll. Most likely I will end up missing my yoga classes that week because "I have too much to do," or maybe I will miss out on that girls' night that will ultimately help recharge me and may even help me to be a better more compassionate caregiver when I am at work.

A balance between work and play is extremely important, but this outlook takes it one step beyond that. It helps to hold yourself accountable for the kind of person you want to be. It forces you to make time in your week for those types of connections and activities that will nurture your soul and help bring balance to your emotional and physical self.

So my list might look like this:
An emotionally/physically healthy woman                       A fun, reliable friend
-3 Yoga Classes                                                                  - Dinner with Jenn on Tues
- 2 Journal Entries                                                                - Call Alicia
- Doctor apt Tues                                                                - Lunch with Lisa
- Pick up inhalers                                                                 - Birthday card for Emily

A supportive supervisor                                                   A compassionate caregiver
- Meet with five supervisees                                                  - Find ZB a hairdresser
- Facilitate staff meeting                                                        - Spend time  w/kids
- Listen, validate                                                                   - Take DC to voice lessons

A contributing board member                                         A  connected family member
- Set up meeting for bylaws committee                                 - Call Sara & Tommy
- E-mail Exec Dir                                                                - Dinner with mom & dad
- Attend meeting Tuesday                                                   - Check in on Uncle Artie
                                                                                          - Invite Aunt Edna to yoga

Now this is sort of an ultimate, balanced list (and it is a hypothetical one), although these are all tasks that are or have been on my various lists.  If you begin to write down your tasks and then realize that your list is lopsided, then maybe you can just take a minute to think about something you could do this week that would fall under one of your more neglected roles. I have found that it helps to just put everything down, get it out of my head, and then take a look at what I am spending most of my energy on (perhaps wasting it on), what areas are being ignored, and how I can purposely nurture those roles which may tend to fall to the bottom of my priority list.

Give it a try, and you might be surprised at how much energy you may be wasting in certain areas, and how you tend to ignore other important and meaningful areas of your life amidst a busy week.  I find that it gives me perspective and helps me focus on what is important in my life, and what I am going to choose to spend my time on this earth doing. It is just another way to actively work toward finding a balance, a connectedness, and ultimately a better you who can be present and compassionate both in and out of the workplace.

The Importance of Supportive Leadership- how we could be doing better

I came home from work extremely frustrated today.  As I thought back on my day, I realize that what was bothering me the most is that when an agency or a program have dysfunction within them (which is far too common in the nonprofit sector, and in group homes especially) at the end of the day it's the clients who suffer from our organizational dysfunction- and they don't deserve it.


To keep with the interest of self care, we have to consider what types of support caregivers are getting from their leadership. Here are some questions I want to consider in this context:

- If we are asking employees to take the time and effort outside of work to actively take care of themselves so they may be the most effective caregivers possible, then what level of responsibility does leadership within the field have to actively take care of their employees when they are at work? 

- What do direct care staff need (and deserve) from administration in order to minimize dysfunction and to create a work environment where people can manage their emotions and do meaningful work?  

- What do staff need from leadership to model the way for self care and connection? 

In my opinion, what staff need from administration is exactly what our kids/clients need from us- to be heard, validated, appreciated,and supported.So what does support from administration look like? Here are some of my thoughts:

 It looks like thank you cards and verbal appreciation when good work has been done. It's in the interest or the intent to find solutions to issues that are making the work environment unnecessarily stressful, or hostile for employees.  It means backing up decisions that your staff team make, its about debriefing after crises with the intent of learning and moving forward and not blaming.  It's about working towards a common goal of taking great care of our clients.

Caregivers need to be supported. Individuals who work with terminally ill patients, or emotionally distraught clients take an emotional hit from the work they do.  Often times decisions or responses result in life or death scenarios, and that pressure alone can be enough to take a serious emotional toll on people. If staff members don't feel supported, they become afraid to make decisions, uncertain in their own abilities to hold their own, and they begin blaming and pointing fingers so as to put the negative light on someone else. A shift happens when a team of employees feel unsupported. The dynamics shift away from a supportive culture (the type of work environment I think we would all love to work in) to a individualized, blaming, "throw-your-coworkers-under-the-bus" culture.   And in any care-taking scenario, this is no good for anyone. 

Caregivers need to feel heard. They need to have a sense of being seen and known. This means if a staff feels strongly enough to bring a concern to management, they should be taken seriously. Staff are looking for their feelings to be validated, just as much or sometimes more than our clients.  This doesn't mean that every complaint results in some type of disciplinary action, but it means that the person bringing forth the concerns is listened too, taken seriously, and that solutions are explored.

Caregivers need opportunities for training, guidance, and supportive supervision, so that they can have the most information possible about 1.) how to do their job to the best of their ability, and 2.) how to be the best caregiver possible while maintaining their own sanity and balance in their life.  Without guidance and close supervision (and difficult feedback where difficult feedback is necessary), staff and management cannot grow to gain the self awareness and tools necessary to manage this type of work successfully. And if we are not giving them the tools, then how can we expect them to do the best job they can?

Caregiving staff need fearless leaders.  We need administration to lead us through the difficult times, to hold the hope for the workers doing the hardest work on the ground.  We need them to stand behind us when we have to give bad news, or to stand with us as we navigate our way through emotionally intense situations. We need validation and understanding that this work is some of the most difficult, important work we could be doing on this earth.

And we mostly need leaders who do not accept mediocrity and dysfunction as "just the way it is in this field." We need you to hold the hope for us, to strive to get great people on board to take great care for our kids.  If administration has the "this is just how it is" outlook, then what it feels like they are saying to those of us who stick around is, "we don't value you as an individual," "you are replaceable to us," "we expect you to leave," "we expect to lose good people, because that's just the way it is."  If administration does not have the vision and the hope that we can realistically run great programs and take great care of our staff and kids, then we will never reach that place of excellence.  If they do have that vision, then they will see that what can get us there is having great people on board; that paying attention to your employees' needs and concerns is actually central in making your programs run well. We owe it to these kids to want to do better, to believe we can do better, and to work day in and day out to make sure that we don't settle for anything less.

Without supportive leadership it becomes far more difficult to hold the hope for our clients, to manage our own emotions, to find meaning in what we are doing, and to feel that we are appreciated for the difficult, important work we are doing every day. Abandonment and rejection are two of the most difficult issues that the group home kids deal with in their trauma histories, and yet with every staff that leaves due to feeling unappreciated, unsupported, or not heard, we reinforce that trauma, we sever another connection in their life. We become part of the problem, part of the system that continues to disappoint and let these kids down. I really cannot bring myself to believe that any of us are in this field because we want to contribute to the problem.

But here's the major problem: when you don't support your staff, when you accept mediocrity, when you expect good people to leave, you are setting these kids up for more loss, more devastation, and reinforcing what they already believe- that they are the bad difficult kids that no one wants to care for. This is what is so heartbreaking to me, and where my outrage is rooted. We could be doing better. And we have no excuse not to be.

Holidays for the Caregiver

Taking care of people can be draining at any time of year. But anyone in the caregiving field knows how particularly difficult the holidays can be.  It is a time of year that brings back memories good and bad, it highlights the areas of our lives that we feel may be lacking, it digs up old grief wounds, and makes fresh ones more difficult to bear.  Yet in our roles as caregivers we must put "our stuff" aside for the interest of our clients. And better yet, we aren't just asked to put our stuff to the side, but we are asked to take on our clients "stuff." We are asked to sit with them as they experience their own struggles, to be empathetic and genuine in our concern, to check our stuff at the door so that we can be emotionally regulated while we are caring for someone else.

Easier said than done, right? Especially when the difficulties we see our clients going through begins to weigh even heavier on us than our own lives. Anyone working with children in congregate care such as residential treatment centers, detention, foster care or group home settings are painfully aware of the difficulties that this time of year brings about for our kids.  All of a sudden the most high functioning of your kids has a giant meltdown, or the girl that finally was going home for her first Christmas in years ends up in the hospital for a psych evaluation and can't go home. It can make you start to question your effectiveness as a caregiver, or the effectiveness of the program you work in. It can start to bring about the despair that comes from witnessing the hopelessness in our kids eyes during the holidays.

To sit with our kids through some of the most intense feelings they will experience takes a toll on us.  And the better we are as caregivers, the more empathy and the deeper the connections we have with our clients, thus the greater the toll can be. This "toll" that I am talking about is called vicarious traumatization, and man the holidays are prime time for it!

As I witnessed the struggles that the group home kids were faced with over the past month, I began to feel a sense of something like survivor's guilt. I found myself feeling less enthusiastic about my own holiday plans. Why do I deserve to have a great holiday when these kids are stuck in detention or hospitals or residential treatment centers? I began dreading the fact that I would have to interact with over 50 of my closest family members on Christmas Eve, and the fact that my birthday is December 20th and people were going to give me presents. I had thoughts like, "Give me presents? When there are kids that don't even get to see their family on Christmas? I want nothing to do with presents!

Instead of focusing on how thankful I am to have such a wonderful family, and how much fun Christmas Eve always is, I began feeling guilty. I started dreading the parties and the interactions to come, because all I felt like talking about was how stressful work has been, and how terribly I am feeling for the kids. I couldn't handle the thought of one person coming up to me and talking about their problems with me.The thought of my cousin picking my brain for advice on raising teenage girls made my skin crawl.  And most of all I dreaded answering the question "So, how's work going?"

But in hindsight I couldn't have been more off base with my assumptions about what I needed.  My lesson of the 2010 holiday season was that ultimately the things that I was dreading because of my vicarious traumatization, were exactly what I needed to experience to pull myself out of this holiday funk. Being with family, laughing together, and making great new memories was rejuvenating and actually played a big part in my self care over these last couple of weeks.

To take time to spend with the family you are fortunate to have, the friends that will support you through difficult times, to share meals and laughs, these are the necessary things to surround ourselves with so that we can be rejuvenated, reminded of our roots and life's purpose, and to ultimately reinforce our decision to be caregivers.  The major thing that I have noticed about vicarious traumatization in the past weeks is that often the very thing that I am dreading or avoiding, might be just the thing that I need to push myself to do in order to reignite compassion and emotional balance in my life.

So here's to all of the congregate care workers out there, especially the direct line staff who sit with the kids day in and day out through one of the most difficult and painful times of the year. Don't forget to nurture the connections in your life even if it means pushing yourself to do it, and to take some time for yourself when you need it.  You couldn't be doing more thankless and important work!

"Be Fearlessly Resilient"

Last month I attended the Massachusetts Women's Conference.  I had no idea what I was about to witness, as over 6,000 women came together to discuss leadership, entrepreneurial insight, perseverance, and resilience.

The room where we gathered in the morning and reconvened for lunch, was an impressive sight of over 600 tables with red poinsettia center pieces, each surrounded by powerful business women, newly established entrepreneurs,  and up-and-coming leaders.  It was definitely a sight to behold.

 Surprisingly enough, my favorite speaker of the day was Glenda Hatchett (i.s. Judge Hatchett from TV). One of the lessons that I learned was that the delivery of your speaking has as much if not more influence on the impression you leave with people than the content you are speaking about.  She was a genuine, enthusiastic speaker, who provoked compassion and motivation from the thousands of listeners in her 15 minute speech.

"Being fearlessly resilient." was the theme of the day. The word resiliency has come up a lot for me lately. I recently posted the following quote on my facebook status:

Resilience is rooted in a tenacity of spirit—a determination to embrace all that makes life worth living even in the face of overwhelming odds. When we have a clear sense of identity and purpose, we are more resilient, because we can hold fast to our vision of a better future.

This concept is important for our self care.  We work with clients and patients everyday who have deep resilience in the face of whatever odds they face.  To tap into your own resiliency is a powerful and healing thing.  We not only have to focus on the good of our work and the life lessons that we learn from these resilient amazing people, but we can hopefully find peace in that our life's work is in line with our personal  identity and purpose. If this is the case then we will be rejuvenated, energized, and reminded of why we do the work we do.  It will give us strength and hope and the ability to persevere in the face of overwhelming odds.

The girls in my group home can be so difficult and emotionally draining to work with, but yet when I stop and think about what they have been through, what they continue to go through, and what they are able to do in the face of all of that, my anger, resentment, or frustration toward them tends to melt away. Instead, left behind is respect. 

People seem to be alarmed when a resident has a difficult time connecting with a particular staff member, or is verbally aggressive, or withdrawn from them. My response to this type of statement is always that Isn't this actually what we should expect from these kids? What we should have been surprised about was that she could connect with anybody at all. But yet I watch as girls come into the program and put themselves out there time and time again, even when the main thing they have experienced in life's relationships is pain. The resiliency that I am witness to everyday makes the difficult days much more worth it, and if I consciously focus on their resiliency, it gives me strength to be a better caregiver for them.

Another major lesson that I took from the conference is how important it is to have a cheerleader, a mentor, someone in your corner who is genuinely interested in seeing you succeed. So here is a shoutout to my Aunt Ellen, for inviting me to go to the conference, for attending it with me, for being my cheerleader, and for reminding me of my own resiliency, passion, and worth. It was a wonderful rejuvenating day, the kind that all types of caregivers deserve!