By Dr Tanya Tierney, Assistant Dean, Clinical Communication, LKCMedicine
It goes without saying that the COVID-19 pandemic has stressed our community in so many ways.
Whether you are a student, staff, faculty or a clinician, the pandemic and the safe management measures that are needed to keep us safe have disrupted our lives at work and at home. We have changed the way we work, the way we study, the way we interact with friends and family and experienced separation and isolation in a multitude of ways.
It is increasingly acknowledged that COVID-19 has created a mental health crisis. As well as an increase in the incidence of mental illness (e.g. depression and anxiety), we have also seen a more widespread impact on emotional wellbeing. This has prompted campaigns to increase awareness of mental health and encouragement to look after our mental health and actively practise self-care.
There are many ways that we can practise self-care, but in this article, I would like to introduce some specific techniques that I teach in the “mindful self-compassion” and “self-compassion for healthcare communities” courses.
Mindful self-compassion is simply the act of supporting ourselves in the same way we might support a dear friend who is having a hard time and has shown to enhance wellbeing and protect against stress, burnout and impaired mental wellbeing.
Mindful Self-Compassion has three components.
Step 1: Mindfulness
Our physiological stress response is designed to keep us safe – to allow us to enter “fight or flight” mode to escape the danger. Once the danger has passed, our physiology returns to a resting state. However, our stress response is the same, regardless of the stressor: a difficult situation at work creates the same rise of cortisol and adrenaline as being chased by a tiger. The kinds of stress we face in our lives don’t go away so our body finds itself in a prolonged “stress response” and we just keep going. Sometimes we don’t even know we are stressed as we are so accustomed to pushing ourselves through the challenges.
Mindfulness allows us to notice when we are stressed and, in time, to detect more quickly when we are becoming stressed. Below is a technique that can help you identify and acknowledge stress or difficulty. You can try this now, or at points during your day.
- Stop what you are doing
- Take a moment to observe your thoughts and the associated emotions – what is present?
- Name it – “I’m feeling worried/angry/time-pressured/sad”
- Take a moment to scan your body – can you locate emotion you identified in your body? A tenseness in your shoulders, a heaviness in your heart, tightness of breath, a knot in your stomach?
It is only through knowing that we are stressed that we can start to manage it.
Step 2: Common humanity
When we are struggling, we often feel alone – no one else can possibly know how we are feeling. We feel like no one can help. Of course, each of us will experience struggles in different ways (as I say to the students, “I know exactly how you feel” is not a helpful empathic statement!). However, we are all human and we all have times in our lives that are hard.
When we are struggling, it can help to remind ourselves that we are not alone, to say to ourselves, “Others in my situation might feel like I do”. We can reach out to others if we need to share our pain and ask for support. Or we can see how others have managed in similar situations which can help us muster the internal resources to cope.
Step 3: Self-kindness
When we see another person struggling, we often offer support. When we work in healthcare or education or care for other family members, that is what we have to do. But when we are struggling ourselves, we tend to use harsher words and a more critical voice, “How did I let this happen?” or “I’m not good enough”.
Mindful self-compassion teaches us to respond to ourselves with kindness, to support ourself in the same way we might support another person. As well as supporting our own well-being, it allows us to be more present for the other – only when we include ourself in the circle of compassion can we have the resources to be compassionate to others. We can do this with words, “May I know that I am enough”, or with gestures (e.g. a hand placed over the heart). In the same way as these actions soothe a baby, the gentle words and touch of our own hands actually release oxytocin and endorphins, having a direct physiological effect on our bodies.
Our choice of response is driven by the question “What do I need right now”. As well as the immediate actions of placing a hand on the heart or offering ourselves kind words (which can help in the moment), we can also tune into other needs we may have. We may be better able to notice that we need a bathroom break before seeing the next patient, or a 10-minute walk before the next Voice Over PowerPoint lecture, or a good night of sleep before the meeting tomorrow, or to carve out time to take a long weekend and clear some of that leave we have accumulated whilst travel has not been an option. We must know our needs before we can attend to them and these strategies can help us be more in tune with ourselves.
Sometimes we can meet our own needs with some deliberate acts of self-kindness and self-care. But for an increasing number of people this is not enough, and we may become aware that we need additional help. If this is the case, then do reach out to others – a chat with a friend or utilise our School’s wellbeing programmes (House Tutors / Postgraduate Tutors) or the University Counselling Centre for counselling services.
Outside of the school community, there are other mental health resources such as Singapore Association for Mental Health or Community Health Assessment Team. You could also reach out to a doctor for advice and support.
If you would like to learn more about Mindfulness or Mindful Self-Compassion, please contact me ([email protected]). There is an informal practice group that meets one lunchtime a week and is open to staff, students and the wider LKCMedicine community. Currently, these sessions are on Zoom, with occasional in-person sessions run in accordance with safe management measures.
Dr Tierney conducting a small in-person session with her informal practice group
Dr Tanya Tierney is a trained teacher in “Mindful Self-Compassion” and “Self-Compassion for Healthcare Communities”.