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Caring for the Caregiver

It's happened again...and this time I truly did not see it coming. I took the time to have my 7 hours of sleep each night, I ate a good breakfast, I made time to play music with my team-but lo and behold; I am hoarse. My voice is frail, and I dare not sing. The good news is, I have no fever. The better news is that I can hone in on my use of deep listening and expand my string and keyboard repertoire. However, as a therapist, I am finding I need once again to take a look within...how did I lose my voice? And the answer takes me to the return of a familiar theme-and one, even as a seasoned clinician, I seem to keep coming back to: I did not take good enough care of myself. Ugh! I teach and preach this to my students at Hahnemann, and to fellow colleagues at Beth Israel-We have conducted workshops and even a training on "how to" care for ourselves as caregivers/therapists. We use Charles Figely's compassion fatigue scale each year to stay aware. So-I ask myself...how am I at this place again? And then the worst of it is: I can pinpoint the very day that I over-extended. The day I took on too many sessions, no lunch, and no squeeze-out tension time. I did not make time for me. I would like to know about ways our readers care for themselves on the job. What kinds of creative methods do you have in place for yourself and amongst fellow staff? How do you release the tensions of what you absorb? When you read the phrase: "care for your self" on the job...what comes to mind?

Comments
Well, I suppose my job is my schoolwork, really. As a modern dance major I need to be able to take class fully and healthfully. This means spending time outside of class doing my own supplemental exercises to aim for even musculature, since I have scoliosis. Another way to care for myself while being a modern dance major is to sometimes not dance through school. Having dance in a university setting can feel suffocating sometimes since you're always in the same building, seeing the same people, getting the same vibes. I often take an African dance class through a community class and sometimes I spend time in a dance studio by myself or go to a contact improv session. Never enough though. Outside of dance, I feel like I need to balance by doing completely opposite things. That's why I have a math minor.
# Posted By Cressa | 2/9/07 11:20 AM
Wow, this web/bog space is a real gift. I take care of myself by consuming lots of fluids, and eating very healthy food, while increasing my omega 3s, and cod liver oil. My work environment is currently 26% humidity, thus a major vocal cord, and respiratory risk. Fluids and honey are grand essentials in this environment.
# Posted By Ann-Marie | 2/9/07 4:32 PM
With so many good care practices in place Joanna, perhaps it returns to a more basic physical concept. I have two colleagues who spent the first 10 years of their professional lives as opera singers and have now re-trained as music therapists. They are constantly dismayed by the lack of real singing technique and vocal care we learn in our training and thus carry into practice.
I knew that their concerns were well-founded, but when one of them offered a workshop at conference a couple of years ago I was stunned by how poor my care practices really were and how many bad habits I had which contributed to the poor state of my voice.
# Posted By Helen | 2/11/07 4:57 PM
What an excellent topic, Joanne! I've been thinking a lot about this issue in general, and I've also been very conscious of it in my own work. Providing music therapy for folks who have significant trauma histories is hard. It's hard to not be affected by the work, to not get angry, to not get sad, frustrated, want to give up- all that stuff that therapists are taught to call "countertransference" and generally lumped in the "not good" category. We don't have anything in particular in place at our facility, but when I've really had it, I usually go to the piano, drag along a fake book, and play- lounge music, pop, show tunes...whatever. Sometimes I write songs, because it helps me say what's bothering me out loud and to, maybe, gain some perspective. I also journal a lot. That forces me to think about what I might not be choosing to see/hear in the session or the person with whom I'm struggling. I've kind of learned over the years that the stuff that most bothers me when I'm dealing with one of my clients is the stuff that I least want to look at within myself. After I've acknowledged the junk within myself I usually manage to gain a saner perspective. Usually. All of that being said, I don't think I would have survived this long as a therapist without very good clinical supervision. Thanks again for the topic!
# Posted By Roia | 2/11/07 7:50 PM
Great topic! Working as a private consultant with a set amount of hour/hours at over four sites covering over 200 miles a week is exhausting. It certainly takes a toll on both my senses and physical self. Working out and keeping a healthy diet has been essential for the physical part.
To release tension as a music therapist one may think that I'd use music to unwind. But to really unwind I've begun painting. I've had a need to try another creative modality for self-expression and painting has been it. Painting is quiet and doesn't require any instruments to be lugged around. It's tangible and lasts where music making isn't unless it's recorded. All I hear is the canvas and brush and I love it. Another great thing is continuing ed courses. Last year I took a class to help with caring for myself. I took the course 'Music and the Self' at Anna Maria College's, Institute for Music and Consciousness. Loved it. It has helped me tremendously as a musician and music therapist to keep the learning process going. Hope this helps.
# Posted By Sarah | 2/12/07 12:05 AM
Hi Joanne and all,
I also have lots of difficulty with over-extending myself and not eating because of time constraints - both of which are highly hazardous. One very simple thing that I do is to keep essential oil diffusing in my office. I use a ceramic ring on top of the light bulb on my desk lamp, and drop in a few drops of lavender essential oil a couple times a day. It helps pick me up, and I find that all kinds of people stop by simply to say hi and sit in my office for a minute. I guess it must make them feel better, too!!
# Posted By Nancy | 2/26/07 11:45 AM
Hello Joanne! I am so happy to have discovered your blog while I am recuperating from laryngitis and a virus. As a music therapist and singer, I probably slacked off on drinking the eight plus glasses of water (by not refilling my water bottle!) and eating throat lozenges throughout my work day. I also know that I stopped doing my yoga, which definitely replenishes me by forcing me to stop worrying and obsessing about things, and to concentrate on my body. I must turn off the "noise inside my head" in order to focus my attention on moving my arms, legs and torso in different directions, while simultaneously regulating my inhalations and exhalations! I feel both relaxed and energized afterward. I also discovered a less strenuous and just as effective way to replenish: Tai Chi or Chi Gong, both of which I have on DVD and DVR. I need to discipline myself to do it on a more regular basis. Also, I find that if I am going through a stressful situation and am not able to release the anger or disappointment, my throat may suffer. I actually read in Louise Hay's book You Can Heal Your Life, that laryngitis or hoarseness of the throat may be caused by stifled anger or by stifled creativity. So, I have also been meditating on how my anger or creativity may have been stifled. Also, I have found that I experience replenishment and enthusiasm when I make the time to go to a restaurant with other music therapists, or speech therapists, or social workers; we brainstorm about work-related experiences while nurturing ourselves. Finally, the best way I replenish is by watching and taping those Great Performances concerts on PBS by the greatest musicians in every genre from rock to jazz to blues to opera to doo-wop!
# Posted By Marianne | 12/7/07 6:55 PM
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