Your Key to Self-Care Isn’t an Action…It’s a Question

And it isn’t the question you think it is.

In a culture that glorifies doing more, the idea of squeezing in self-care can feel like…well, more-one more task on a never-ending list. Instead of feeling like something we want and enjoy and value, self-care can feel like a “should” or “have to.” And when our schedules overflow, missing self-care can feel like a failure triggering shame and comparison.

This spiral can be even more defeating for mental health professionals. After all, we are exceptionally well educated about the benefits and the options for self-care.

To that point, you may have noticed that therapists and other mental health providers are already implementing ongoing research about the benefits of nature experiences on mental health. This translates to practical applications of the ecosystem service perspective. For some providers this looks like offering sessions in outdoor settings. For some, it includes screening for nature exposure and helping clients identify ways they can include nature experiences in their week. Like many areas of self-care, the research is inspiring...and challenging (Robbins, 2020).

Spending time in green spaces (parks, gardens, wooded trails, etc.) or blue areas (aquatic spaces) has been shown to improve affect, reduce aggression, promote cognitive functioning (including focus and attention), and foster cohesion and social engagement. In addition, spending time in nature is thought to improve sleep, reduce stress hormones, and potentially reduce the risk for some mental health disorders (Bratman et al., 2019). 

At first glance, this seems like an obvious self-care practice that we can easily embrace. After all, spending time in nature is surely something we can multitask. And if other professionals are already doing it, we don’t want to be left behind. How hard can it be?

Actually, it's pretty difficult for some. While the research is promising, the reality is that, like with many options of self-care, implementation is not as easy as it would seem. At this point, the data on nature experiences and mental health indicates that in order for this intervention to be significantly impactful, at least 2 hours of nature exposure per week is needed. And while this time can be spread throughout the week, there are practical considerations that mental health providers cannot overlook (Robbins, 2020).

When considering expanding services to adopt an ecosystem experience, providers must take into consideration appropriate screening strategies to determine ideal candidates by addressing nature-related phobias, physical limitations, and safety concerns. This requires providers to stay abreast of research in a relatively new field. Likewise, providers also need to take into consideration confidentiality, liability, and accessibility for any intervention that is provided. For providers working in urban areas especially, finding access to green and blue spaces can be difficult. Finding access to safe green and blue spaces where patients’ confidentiality will be maintained, may be limited (Bratman et al., 2019).

Compounding these challenges are the ongoing pressures from insurance providers and practice managers to see as many clients as possible in time-limited appointments. Transitioning to and from nature takes time and logistical finesse on several levels. For example, if you are offering sessions in nature, when and how are you documenting your appointment?

Suddenly, a potential self-care modality that many mental health providers love seems out-of-reach and the spiral begins. If other providers are using this modality, why can’t I? What could I do to make this work? Is it enough to just encourage patients to practice spending time in nature themselves? I can’t even get myself into nature so how do I think I can get my patients into nature? If I’m not modeling this type of self-care, am I even a good provider? Can I bring nature into my office? Who would pay for that?

These struggles don’t just show up in the realm of implementing newer interventions such as ecosystem experiences as the self-care modality. These struggles show up in every mode of self-care. Unfortunately, in this space we often find that our typical therapeutic modalities are less effective than we would like. When we can’t motivational interview ourselves into changed behavior or reframe our thoughts which are pretty solid in this area, we often jump to a solution-focused approach. For other areas of self-care this looks like:

How do we find the time?

What self-care should we incorporate?

How is everyone else doing this?

Where can I even go to get away?

How much does self-care cost?

And still we struggle to accomplish what we are literally trained and paid to help others do. Before we know it, we are spiraling into imposter syndrome.

What is wrong with me?

Is this burnout?

Am I even qualified to help others if I can’t help myself?

Should I take another training or certification?

What do my colleagues think about me?

But here’s the secret. While some of these questions are valid and worth considering, the first and most important question to ask yourself about self care is not “what” or “how.” It’s “why.”

The question that alludes us most is the one that got us into mental healthcare in the first place. And, because we tend to assume that this is a question that has already been asked and answered, it tends to slip by us during times of personal or professional struggle.

Why does practicing self-care matter to me? Why do I value this particular modality?

It’s not the miracle question, but it creates space for it. When we firm our foundation with our values, we create an opening for more helpful questions to flow-the mindset questions.

Are my actions moving me towards or away from my values?

Is there a story I am telling myself that is keeping me from acting in alignment with my values?

If so, where did this story come from? Do I want to change this story? Who benefits from the continuation of this story?

Am I communicating my values clearly-to myself and to others?

Who knows and supports me in my efforts to live in alignment with my self-care values?

What would be different if I practiced self-care consistently?

These are the questions that fire us up, propel us further, and create momentum for the action we need.

When applied to an opportunity to try a new model of self-care or include this model in our practice with our patients, asking “why” first, can be critical to successful implementation. For example, values that may resonate with the ecosystem perspective for nature experiences might include exploration, creativity, ecology, flexibility, leisure, health and fitness. Limiting stories might include a narrative from our academic training of professionalism occurring in a particular setting or with a specific degree of environmental control.

If we ask ourselves “why” first, we create space to identify our values and then consider our options more clearly. If I lean-in and move toward these values, could it be possible that my health, as an individual and a provider, might grow alongside the health of my clients? Can the leap to that path be broken into manageable steps?

More often than not, when we start from “why,” not only will we find clarity, we’ll also find the motivation spiral we are looking for and that is a wonderful spiral to be in. Meaningful action leads to motivation that leads to more meaningful action.

So when you find yourself in struggle and lacking the self-care practices you need, take your pause, take your breath, and ask yourself…”Why”?

References:

Bratman, G. N., Anderson, C. B., Berman, M. G., Cochran, B., de Vries, S., Flanders, J., Folke, C., Frumkin, H., Gross, J. J., Hartig, T., Kahn, P. H., Kuo, M., Lawler, J. J., Levin, P. S., Lindahl, T., Meyer-Lindenberg, A., Mitchell, R., Ouyang, Z., Roe, J., … Daily, G. C. (2019). Nature and mental health: An ecosystem service perspective. Science Advances, 5(7). https://doi.org/10.1126/sciadv.aax0903

Robbins • January 9, Jim. “Ecopsychology: How immersion in nature benefits your health.” Yale E360, Yale School of the Environment, 9 Jan. 2020, https://e360.yale.edu/features/ecopsychology-how-immersion-in-nature-benefits-your-health.

Guest Blog Article Written by: Heather Herman is a dually certified Family Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner. In her private practice she sees clients in NC and VA and specializes in perinatal mental health. Heather is also the founder of Mental Health Connector where she makes finding support easy for providers and their clients. Everyone needs mental health support and support begins with connection!