The Changing Context of Self-Care

By David S. Prescott, LCSW, LICSW, ATSA-F

It was just a few years ago that professional organizations began to include self-case in their codes of ethics. The American Psychological Association, Canadian Psychological Association, National Association of Social Workers, and American Counseling Association, to name a few, have all increased their focus on self-care. For many, this is not news. It has long been known that exposure to the traumatic actions and experiences of our clients can take a toll. Forensic psychiatrist John Bradford is an excellent example of someone who has been honest about this.

Looking back to an APA article from 2014, it can be interesting to see how self-care is described:

“Self-care has been defined as providing adequate attention to one's own physical and psychological wellness… As trainees, we receive mixed messages — perform at a high level and meet all rigorous training demands, while making time for outside activities, relaxation and fun… It is an ongoing challenge to make time for self-care (relaxation, sleep, time with family and friends) in graduate school… I feel that I have finally learned the value of self-care, in addition to the value of work. It is possible to find balance.”

 Likewise, the APA website has the slides from a presentation on “psychological wellness and self-care as an ethical imperative.” The slides describe that self-care is necessary due to distress, burnout, vicarious trauma, and (preventing) impaired professional competence. The slides are silent on what kinds of activities count as self-care. Elsewhere in media, much is made about the role of gratitude; less is made of kindness.

How have self-care activities been framed in the past? The examples above include outside activities, relaxation, and fun; finding balance; sleep; time with family and friends. A more in-depth article from a positive psychology resource includes things like treats and delineates micro and macro self-care. Macro self-care includes “’the important traditional category of self-care that includes the big stuff,’ such as eating well, getting enough exercise, taking a vacation, and forming positive relationships.”

Interestingly, there is rarely any mention in the primary texts of the role of spirituality, including spiritual pathways or religious activities. These are significant sources of comfort as well as meaning and purpose in the lives of so many. Amid all the discussion about eating right and exercising, why isn’t more attention paid to the activities that bring us closer to the core of our identities? Why is there so little about what brings us joy? Or fills us with awe and wonder? A friend colleague recently described going outside on a clear night and looking at Polaris (the North Star) and reflecting on all the roles that it has played to others across time, place, and culture, including as a navigational aid for mariners trying to find their way.

Of interest here in the current era is how much clearer the context of our stresses has become. Where we have long talked about vicarious traumatization, we are only beginning to recognize the role of workplace toxicity as a broader issue. A 2022 survey found that one in nine US workers described their workplace as toxic (with the primary causes being bad leadership, unclear job roles, and harmful social norms). Likewise, a recent report in the UK notes:

“We surveyed over 2,000 employees across various industries and a staggering 75% of them have experienced a toxic workplace culture. Of those, 87% of respondents also agreed that a toxic workplace culture has negatively affected their mental health” (Emphasis in original).

Attempting to ameliorate similar effects, a colleague recently advertised a training on workplace bullying in social media and received vicious responses from anonymous strangers. One might wonder where on Earth self-care begins in this scenario, with one obvious solution being a social media hiatus and digital detox.

Likewise, in this time of uncertainty, many of us are seeing workforce and funding cuts and the resultant anxiety, stress, and depression. It is no surprise that there has been an increased recognition of institutional betrayal and betrayal trauma. It is no wonder that our colleague and meditation advocate, Janet DiGiorgio-Miller frequently emphasizes the importance of simply checking in with colleagues and asking, “How are you doing?”

Where self-care was once about bubble baths and beach vacations,  we realize that it’s not as simple as taking time off from stress; sometimes it’s inescapable. A strong meta-message in the past has been that if you’re burned out or otherwise can’t cope, it might be because you haven’t done enough yoga and meditation. Self-care, like our states of mind is no longer simply about the toll that our work with clients can take or the stress that occurs when we’re behind in paperwork.

Having experienced suffering and social injustices in his home country of Vietnam, Thich Nhat Hahn talked about the importance of “engaged Buddhism,” in which meditation and the study of Buddhist ethics are not just a way of coping, but of staying engaged in times of injustice and suffering. Likewise, even the Black Panthers strongly advocated self-care as vital to the survival of the Black community, especially at a time when they couldn’t trust a government that was almost entirely white. They focused on areas such as health care, housing, and childcare – all things based more on community needs than the individual. Less known is that Rosa Parks was a yoga practitioner against a backdrop in which self-care was not seen as a luxury but a way to become more empowered. Understanding that our experiences cannot be compared to theirs, to what extent, and in what ways, might we learn from these examples to benefit ourselves, others, and the communities we serve?

Ultimately, self-care can mean many things. It can take the form of individual time spent recharging, and it can involve communities taking care of themselves when no one else will. It might be that special spa day that provides brief respite, or it could be that opportunity to rest with a specific goal of getting back to the work of helping others and overcoming the toxicity that can overtake us if we’re not careful.