Recently, just before the news of Melbourne's lockdown extension broke, I asked a friend and colleague how she was coping. We work within prison based forensic mental health services, and carry a heavy psychological load, within an oft-chaotic environment. "Weltschmerz", my colleague said, "life pain".
Later that day. I spoke to a new colleague about ways to manage and process the intense trauma experiences some of our forensic clients hold. We noted the intensity of what she has seen and heard, and talked about how she is processing it. As the day progressed, I noticed my tread grow heavier. By the time I arrived home, I felt doubled over with weight. The weight of the work I carry, the sadness I have absorbed, mirrored and reflected on. The weight of shouldering other people's wellbeing. The weight of always being the carer.
Other people I have spoken to have echoed the same thing. Most of my friends and colleagues are in the health profession and disproportionately tend to inhabit caring roles in many of their relationships, including predilections toward self-sacrifice ("just one more client"), perfectionism ("I need to change this person's life") and subjugation ("other people have it worse than me, I can't complain"). These tendencies have been amplified during the pandemic, as we have seen the intense need and have leapt to support people, sometimes providing eight to nine daily sessions of therapy, and cancelling leave.
We tend to be stoic, and say "fine" when asked how we are. Usually, we are fine. Usually, this is OK. Usually, these tendencies are balanced by the counter-weight of close relationships, the buoyancy of holidays, the effervescence of the out-of-work being.
Right now, we have inhabited 18 month of bleakness, personal disappointments, separation from support network, and grief. Some health workers are burnt out, the rest of us are teetering on the edge, even as we try to pick ourselves back up, for our clients and for each other.
When I expressed feelings of stress recently, I had a flood of support from peers. We turn toward each other in the mental health world, instinctively recognising that the only counter-weight needed sometimes is the deep seeing of another person, including their pain.
My own therapist booked in an appointment with me withing a few days after I reached out. "Thank you," I said gratefully, aware of the pressure of waitlists. "It's ok, just text whenever you need a session," she said. We spoke about the tasks I had been juggling and my well-established tendency to ignore the need for rest and to withdraw when under stress. We spoke about ways I could reduce some of my load, and some soul-nurturing things I could do in the meantime. Later, I spoke to peers and managers, who were all unequivocally supportive of taking time off, and solicitous of my well-being.
We spoke about the tasks I had been juggling and my well-established tendency to ignore the need for rest and to withdraw when under stress.
I went for a walk with my dog that evening, and felt lighter than I had in months. I texted a few friends to check in with them, and stopped to look at some magnolia blossoms. I booked in a Zoom yoga class.
As it turns out, the first step to caring for the carer involved an acknowledgement that I needed care, and that I deserved to seek care. It involved turning toward and fully acknowledging the pain I was experiencing and what I needed to soothe this pain, instead of pushing it away behind defences of "other people have it worse".
When thinking of caring for the carer, I use a few simple principles.
Reflect
Pay close attention to the costs of this pandemic and the impact it may have had on you. Notice your discomfort, and allow yourself care.
Respect
Respect your own need for rest and your own limitations.
Respect the limitations of the system you work within, your role, and that one person cannot be everything or help everyone.
Respect that you might be operations at a reduced capacity. Aim for 70 per cent, not a 100 per cent. Forgive yourself. Be kind with your self-talk.
Reach out
Allow yourself to seek support from other people, health professionals, peers, friends and family.
Ask for support in ways that you need most, whether practical (a cooked meal) or emotional (a text check-in).
Manage the beliefs that say you are not entitled to have care, or allowed to stop work.
Remember aufgehobensein: a sense of belonging to a greater whole. And who could fail to be lightened by the German word for lightbulb: glühburne, glow pear.
Replenish
Notice what gives you sustenance and rest. For some, it will be raucous zoom drinks, for others, a book, a couch and a candle.
Check in with yourself daily and note your energy levels and mood to see what you need.
Leave one appointment slot free, say no to booking in that one extra client and nap instead.
Write that research paper next year.
Remain
Remain present to yourself. Practice a loving-kindness meditation, or some slow yoga.
Remain open to the small gifts of being you can give yourself. An extra hour in bed, one less client for the day, one nice candle, a bath. These daily moments provide ballast for the self against the tugs of the world.
Remember
Remember the values that drew you to this profession; the willingness to sit with suffering, the capacity for patience, gentleness and hope. These values still exist, and serve as anchors.
Remember that your clients need you, and that they need you to remain compassionate without being burnt-out.
My friend with weltschmerz sent me a message the day after our initial conversation, "Remember aufgehobensein: a sense of belonging to a greater whole. And who could fail to be lightened by the German word for lightbulb: glühburne, glow pear," she said. I chuckled to myself, grateful for the glorious web of humour, help and healing I inhabit, my own weltschmerz suddenly lightened.
Dr Ahona Guha, DPsych, is a clinical and forensic psychologist in Melbourne, Australia. She has a specific interest in working with victims of trauma and also works with perpetrators of a range of offending behaviours. She writes about a range of psychology topics at Psychology Today () and can also be found on twitter (@drahonaguha).
