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I have the opportunity to work with many people in the healthcare profession. What I have seen in the last couple years is a strain on the healthcare system and workers that are up against a covid pandemic and limited resources. One thing I am seeing is burnout or compassion fatigue. This happens when you are unable to take care of yourself and continue to care for others. This causes people to quit their healthcare jobs which puts more strain on the ones that stay which increases the rate of burnout that leads to more loss of staff. It is a vicious cycle. Here is a Burnout Prevention Plan for Healthcare Workers.

BURNOUT PREVENTION PLAN

For Healthcare Professionals

1. Prayer: Praying to a Higher Power of your choosing can be helpful to determine what you have control over and what you don’t have control over. Giving the things you don’t have control over to a Higher Power can help you use your energy on the things that you can control. A Higher Power can bring a sense of peace in knowing there is a greater being that can take care of the things you don’t have the ability to take care of. This includes patients or other people in need of help.
2. Know Your Limitations: Recognize that you are human. You will not be able to help everyone that needs help. It is important to allow others to care for the people that you are unable to care for. Try to recognize when you are out of energy or need time to practice self-care. Be open about this to trusted colleagues or friends and allow people to step in and take over if possible.
3. Look at the Bigger Picture: When things feel hopeless or you feel you are not making a difference, think of 1 person that you helped heal. Think of the people affected by this persons healing. That 1 person will positively impact multiple people and those people will then positively affect others. This positive impact is never ending.
4. Manage Expectations: Prepare for the worst and hope for the best in your job. Take time to enjoy the beautiful things that surround you daily. Be grateful of the things that are positive in your life. It can be helpful to write down 3 things you are grateful for every day.
5. Keep Perspective: You are 1 person. You cannot do everything alone. Receiving and asking others for help is important to reach the goal of helping someone.
6. Take Time For You: Find things you can do that help you feel inspired. Do things that help lift your spirits. Try new things. Laugh. When working 12 to 24 hour shifts this can seem impossible.Even taking 5, 10, or 15 minutes out of the shift to walk or admire artwork on the walls can be helpful.
7. Strive to Move Forward: Take 1 day at a time. Sometimes 1 minute at a time. Do what helps to leave a legacy behind. This is done when you help patients, or just using kind words when speaking to family members of a patient.
8. Deal with Reality: Focus on doing the next right thing. Create a goal to leave this world a better place. This can be done by just being kind to others; patients, family members that are grieving, and colleagues.
9. Strive to Challenge Fears: Face your fears and challenges. Do not allow the fear to control you. Step out of your comfort zone when you can and when appropriate to face your fears. This will decrease a feeling of fear in these situations.
10. Utilize the Serenity Prayer: Even if you are not a Christian, the Serenity Prayer can be helpful. It helps you identify the things you can’t control and helps you ask a Higher Power for help with this.

The Serenity Prayer

God (or Higher Power, Nature, Universe, etc.) Grant me the Serenity

To Accept the Things I Cannot Change

The Courage to Change the Things I Can

And the Wisdom to Know the Difference.

This prayer is about being at peace with yourself and when connected to something greater than you. It helps you recognize that there will be people you are unable to help. It assists you in learning how to detach with love and not with guilt. It gives you the courage to be humble and recognize you can’t save the world and that you are human. The wisdom is knowing when you need to recharge and when it is better to detach from the patient or situation. It helps identify when and how you can help. It teaches you to choose your battles and invest yourself in the things that will be the most beneficial for yourself and the patient.

Quotes:

“One person can make a difference and every person should try.” – John F. Kennedy

“Act as if what you do makes a difference. IT DOES.” – William James

“When you get tired, learn to rest, not quit.” – Banksy

“You always gain by giving love.” – Reese Witherspoon

“You will face many defeats in life, but never let yourself be defeated.” – Maya Angelou

“Don’t judge each day by the harvest you reap but by the seeds that you plant.” – Robert Louis Stevenson

“Ability is what you’re capable of doing. Motivation determines what you do. Attitude determines how well you do it.” – Lou Holtz

“If it wasn’t hard, everyone would do it. It’s the hard that makes it great.” – Tom Hanks

Reference: Gorski, T. (2021). My burnout prevention plan. Gorski-Books.

Alcoholism or addiction does not just impact the person using; it impacts the whole family. The person abusing substances tries to convince themselves that they are not affecting anyone. This is a form of minimization that is common with people that have addiction issues. There are now support groups, many 12 step based, that focus on Adult Children of Alcoholics, or ACOA. This is due to the resulting issues adults face when they are raised in an alcoholic/addict home.

Characteristics of Adult Children of Alcoholics

Adult Children of Alcoholics:

• Guess at what normal behavior is.
• Have difficulty following a project through from beginning to end.
• Lie when it would be just as easy to tell the truth.
• Judge themselves without mercy.
• Have difficulty having fun.
• Take themselves very seriously.
• Have difficulty with intimate relationships.
• Overreact to changes over which they have no control.
• Constantly seek approval and affirmation.
• Usually feel that they are different from other people.
• Are super responsible or super irresponsible.
• Are extremely loyal, even in the face of evidence that the loyalty is undeserved.
• Are impulsive.

On the Adult Children of Alcoholics website, they define codependency related to ACOA as the following:

• My good feelings about who I am stem from being liked by you.
• My good feelings about who I am stem from receiving approval from you.
• Your struggle affects my serenity. My mental attention focuses on solving your problems/ relieving your pain.
• My mental attention is focused on you.
• My mental attention is focused on protecting you.
• My mental attention is focused on manipulating you to do it my way.
• My self-esteem is bolstered by solving your problems.
• My self-esteem is bolstered by relieving your pain.
• My own hobbies/interests are put to one side. My time is spent sharing your hobbies/interests.
• Your clothing and personal appearance are dictated by my desires and I feel you are a reflection of me.
• Your behavior is dictated by my desires and I feel you are a reflection of me.
• I am not aware of how I feel. I am aware of how you feel.
• I am not aware of what I want- I ask what you want. I am not aware- I assume.
• The dreams I have for my future are linked to you.
• My fear of rejection determines what I say or do.
• My fear of your anger determines what I say or do.
• I use giving as a way of feeling safe in our relationship.
• My social circle diminishes as I involve myself with you.
• I put my values aside in order to connect with you.
• I value your opinion and way of doing things more than my own.
• The quality of my life is in relation to the quality of yours.

If you find that you can relate to these things, you may benefit from counseling or a support group for Adult Children of Alcoholics. You can find meeting locations and online meetings at adultchildren.org.

I have heard from people lately that they feel that people seem angrier now. They talk about seeing violence more on the news, or they may even witness it in person. Some talk about how unfriendly people is in the grocery stores. Some have chalked this up to the stress we have experienced this past year due to COVID-19 and the civil unrest that seem to increase with it.

I was really thinking about this and came up with another thought. What about smiling? What about seeing an old friend at the gas station and giving them a big hug or a heartfelt handshake. What about being able to rekindle old friendships at a class reunion? Or gathering a family to celebrate a graduation, or baby shower, or even a wedding? These are things many people have missed out on for over a year.

How Masks Have Affected Mental Health

Many people have reported feeling more anxiety related to seeing people in masks. They have a sense of uneasiness and feel people appear more threatening (mind.org, 2020). I thought about this and realized that we were not able to see people smile. We might smile at someone but there is no way that they would know that. Or we do not smile at all, recognizing people cannot see it due to the face coverings. This got me thinking about how smile is related to mental health and healthy interactions with people.

Benefits of Smiling

• Smiling releases neuropeptides in the brain which helps to reduce stress.
• Smiling releases dopamine, serotonin, and endorphins which are the chemicals in the brain that give a person a sense of wellbeing.
• The endorphins released when smiling is a natural pain killer.
• The serotonin that is released when you smile is a natural anti-depressant and decreases anxiety.
• Studies show that if you smile, people will treat you differently. This is because when smiling you are viewed as attractive, reliable, relaxed, and sincere.
• Studies also show that when seeing a person smile your brain feels like it has been rewarded which is mood lifting.

So, when you are in public and choose not to have a mask, take time to smile at people. It not only benefits them, but it also benefits you!! If you choose to wear a mask, take time to say hi to people or ask them how they are doing. If they cannot see your smile, at least they will be able to hear it which is the next best thing!!

References: Mind (mind.org, 2020). Mask anxiety, face coverings, and mental health.

Riggio, R. (2012). There’s magic in your smile. Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/cutting-edge-leadership/201206/there-s-magic-in-your-smile.

Guilt: A feeling you get when you did something wrong, or perceived you did something wrong.

Shame: A feeling that your whole self is wrong and it may not be related to a specific behavior or event.

Guilt:” I did something bad.”

Shame: “I am bad.”

GUILT

People tend to think of guilt as a negative emotion; or an emotion that they feel they should not be feeling. However, guilt is vital for our society. Guilt is what can keep someone from hurting others. It causes us to think about our actions that may have caused harm and then make changes to avoid causing that harm again.

It has been shown that people who are more prone to guilt are less likely to experiment with substances, are less likely to participate in criminal activity, less likely to commit suicide and are more likely to have safe sex.

SHAME

Shame on the other hand can be unhealthy and even become toxic. People with shame have been shown to be more likely to have unsafe sex, drink alcohol at an earlier age and are less likely to apply for college. Shame can lead to feelings of inadequacy that can have a negative impact on people and cause things like low self-esteem and low self-confidence.

Some people feel shame for things they have done, however others may feel shame for things that have happened to them. Childhood sexual abuse results in high levels of shame. Children have trouble processing what has happened to them and take responsibility for things that are not their fault. This also happens to adults who are victims of assault or abuse.

HEALING

One way to heal from shame is to begin retraining the brain. People with shame have an inner dialogue that is negative and includes negative thoughts and feelings about themselves. People need to begin by recognizing when the negative thinking is taking place and immediately replacing it with a positive thought or a thought that challenges the negative thinking. This has been shown to rewire the brain and help the brain become more positive which in turn helps the person feel better about themselves and helps them heal from the shame.

I recently watched a documentary regarding a missing person in Los Angeles. She went missing while staying at the Cecil Hotel. I had heard about this from the internet due to a surveillance video of the woman going viral. There were many theories about the disappearance; including there being paranormal activity involved or a possible murder. Once she was found three weeks later, it was apparent to most people that she was murdered and put into a water tank on the roof of the building. It was horrifying for anyone that had watched the events unfold. The final conclusion was that the woman actually suffered from Bipolar Disorder and in a psychotic state had jumped into the tank to hide from whatever or whoever she thought was after her. In doing so, she finally did drown. There are many people who are not convinced of this and feel she was actually murdered. What they don’t understand is how Bipolar Disorder works and how this is something that is not far fetched when you are dealing with someone that has this disorder.

Bipolar Disorder is diagnosed when someone is experiencing manic or hypomanic moods along with depressed moods. These moods cause dysfunction in different areas of the individuals life; such as work, relationships, school, etc. Many people with Bipolar Disorder struggle with their medication regimen. Many do not take medication as prescribed which may consist of mood stabilizers, antipsychotics, antidepressants, and medication for anxiety. Many people with this disorder state that they don’t like taking their medications because it causes too many side effects, such as fatigue, sexual dysfunction, or physical effects that are bothersome.

It can be difficult for family members and friends to know how to support someone with Bipolar Disorder. Here are some ideas and ways to support someone you love:

• Educate yourself: It is important to understand the symptoms so you know how to react appropriately when there are mood changes.
• Listen: There are many ways you can show that you care about the person by just listening by actively hearing what they are saying, staying calm, avoiding arguments, and avoiding topics that seem to activate the persons emotions.
• Be a Champion: Show the person that you are on their side when they may feel that everyone is against them.
• Be active in their Treatment: Many people with Bipolar Disorder struggle to follow through with therapy and doctor appointments. It can be helpful to go with them or even sit with them in the waiting room.
• Make a Plan: Bipolar Disorder can be unpredictable so it is good to have a plan in place in case the person becomes suicidal or has other dangerous behaviors. Have daily plans to help the person get through their mood swings and helping them utilize coping mechanisms.
• Support but don’t Push Them: It is important to know when it is time for medical and mental health professionals take over.
• Be understanding: This can be very frustrating for the individual with the disorder. Try to show understanding and empathy to what they are going through.
• Don’t Neglect Yourself: You must always practice self-care, especially when providing support for someone with a disorder like this. Take care of yourself and stay healthy

Reference: Cirino, E. (2020). How to help and support someone with bipolar disorder. Healthline. Retrieved from: healthline.com/health/bipolar-disorder/caregiver-support.

Schema: Self-defeating, core themes or patterns that we keep repeating throughout our lives.

THE ENTITLEMENT LIFETRAP

The following are signs this Lifetrap might be active:

• Trouble accepting no as an answer.
• Getting angry when you don’t get what you want.
• Feeling you are special and should not accept normal constraints.
• Put your needs first.
• Have difficulty getting yourself to stop problem behaviors; such as drinking, smoking, overeating, etc.
• Cannot discipline yourself to complete boring or routine tasks.
• You act on impulses and emotions which gets you into trouble later.
• If you cannot reach a goal, you become easily frustrated and give up.
• You insist people do things your way.
• You have trouble giving up immediate gratification to reach a long-term goal.

The following may be why and how this Lifetrap developed:

• Weak Limits: You may have been given whatever you want. You were not taught frustration tolerance.
• Dependent Overindulgence: You were overindulged by parents so you then became dependent on them.

The following are ways to break this Lifetrap:

• List the advantages and disadvantages of not accepting limits.
• Confront the excuses you use to avoid accepting limits.
• List ways your problem with limits manifests itself in everyday life.
• Ask for feedback as you try to change.
• Try to empathize with people around you.
• If you have self-discipline problems, make a hierarchy of tasks and work your way up.
• If you have difficulty controlling your emotions, develop a “time-out” technique.
• If you have dependent entitlement, make a hierarchy of tasks in terms of difficulty. Gradually do tasks you usually let others do for you. Start proving to yourself that you are competent.

With structure and patience with yourself and others, you can improve this Lifetrap to have more meaningful relationships.

Reference: Young, J. & Klosko, J. (1994). Reinventing your life. Penguin Books. London, England.

Schema: Self-defeating, core themes or patterns that we keep repeating throughout our lives.

THE UNRELENTING STANDARDS LIFETRAP

The following are signs that this Lifetrap might be active:

• Not being able to accept being second best. You feel like you have to be the best at everything you do.
• You feel like nothing you do is quite good enough.
• You strive to keep everything in perfect order.
• You have to always look your best.
• You have no time to relax because you feel like you have so much to accomplish.
• Your relationships suffer because you punish yourself so hard.
• You put yourself under so much pressure your health suffers.
• You feel you deserve strong criticism when you make a mistake.
• You are very competitive.
• Wealth and status are very important to you.

The following may be how and why your Lifetrap developed:

• You felt your parents love was conditional on meeting high standards.
• One or both parents were models of high, unbalanced standards.
• Your unrelenting standards developed as a way to compensate for feelings of defectiveness, social exclusion, deprivation, or failure.
• One or both parents used shame or criticism when you failed to meet high expectations.

The following are ways to break this Lifetrap:

• List the areas in which your standards may be unbalanced or unrelenting.
• List the advantages of trying to meet these standards on a daily basis.
• List the disadvantages of pushing so hard in these areas.
• Try to conjure an image of what your life would be like without these pressures.
• Understand the origins of the lifetrap.
• Consider what would happen if you lowered your standards by 25 %.
• Try to quantify the time you devote to maintaining your standards.
• Try to determine what reasonable standards would look like from getting opinions of balanced individuals.
• Gradually make changes to your schedule or change behaviors in order to get your deeper needs met.

You can live a more healthy and relaxed life when you work through this Lifetrap.

Reference: Young, J. & Klosko, J. (1994). Reinventing your life. Penguin Books. London, England.

Schema: Self-defeating, core themes or patterns that we keep repeating throughout our lives.

THE SUBJUGATION LIFETRAP

The following are signs this Lifetrap may be active.

• You let other people control you.
• Being afraid if you don’t do what people want, they may retaliate, get mad, or reject you.
• Never felt you were able to make your own decisions.
• Have trouble demanding people respect your rights.
• Worry about making other people happy and trying to get their approval.
• Try to avoid confrontation.
• Feel you give more to people than you get back.
• Usually take care of people close to you because you feel others pain so deeply.
• You feel guilty if you put yourself first.
• Feel like you are a good person because you think of others before yourself.

The following may be how and why this Lifetrap developed:

• Your parents may have tried to dominate or control your life.
• If you did not do things their way, your parents punished, threatened, or got angry with you.
• If you disagreed with them on how to do things they may have cut off contact with you or withdrew emotionally.
• You were not allowed to make your own choices as a child.
• You may have had to take care of family members because your parents were not around often.
• Your parents talked often to you about their personal problems so you were always in the listener role.
• If you did not do what your parents wanted they made you feel guilty or selfish.
• Your parents might have taken care of everyone else’s needs while ignoring their own.
• You did not feel your rights, needs, or opinion were respected.
• Your parents may have had a tendency to become worried or depressed so you were careful about what you said.
• You may have been angry that your parents did not give you freedom like other children.

The following are ways of breaking this Lifetrap:

• Understand you childhood subjugation and feel the child inside you.
• List situations at home and work where you subjugate or sacrifice your needs to others.
• Start forming your own preferences and opinions. Learn about yourself and your needs.
• Make a list of what you do or give to others and a list of what they do or give to you.
• Don’t be passive-aggressive. Be assertive and express what you need or want.
• Practicing asking for other peoples help. Discuss your problems with people. Achieve a balance of give and take in your relationships.
• Pull back from relationships with people that are self-centered or selfish and get out of relationships where you feel trapped.
• Practice confronting people and accommodating so much. Learn to express anger assertively right away and learn to be more comfortable when people are upset or mad at you.
• Don’t rationalize your tendency to please others so much.
• Review your previous relationships and identify a pattern pf choosing partners that are controlling or needy. List warning signs you should avoid. Try to avoid people who are selfish, irresponsible, or dependent.
• Be more assertive at work and take credit for what you do. Do not let others take advantage of you. Ask for promotions or raises you are entitled to. Delegate to others.

With time and patience for yourself, you can break this Lifetrap!!

Reference: Young, J. & Klosko, J. (1994). Reinventing your life. Penguin Books. London, England.

Schema: Self-defeating, core themes or patterns that we keep repeating throughout our lives.

THE FAILURE LIFETRAP

The following are signs the Failure Lifetrap is active:

• Feeling like you are less competent then other people.
• Feeling like a failure when it comes to achievements.
• Feeling most people your age are more successful.
• Feeling like a failure as a student.
• Feeling less intelligent than people you associate with.
• Feel humiliated by failures with work.
• Feeling embarrassed around others because you don’t feel you measure up.
• Feeling that others think you are more competent than you really are.
• Feeling you have no special talents that really count.
• Feel you are working below your potential.

The following is the way this Lifetrap may have been developed:

• You had a parent that was critical of you. You may have been called names, such as dumb, failure, etc. This parent may have been abusive.
• One or both parents were successful and you believed you could never measure up to their standards so you stopped trying.
• You may have felt that your parents either did not care if you succeeded, or they were intimidated by your success. The parent may have competed with you. They may have worried about losing your companionship if you were successful.
• You felt inferior to other kids because you were not as good in school or sports. You might have been uncoordinated, had short attention span, or had a learning disability. You may have stopped trying in order to avoid humiliation.
• You were compared unfavorably to brothers and sisters. You stopped trying because you believed you could not measure up.
• You may have come from another country or your family were immigrants. You may have had less money then classmates. You felt inferior to your peers.
• Your parents did not set enough limits for you. You did not learn self discipline or responsibility. You may have failed at homework and studying. This led to failure eventually.

The following are ways of breaking this Lifetrap:

• Access if your feelings of failure are accurate or distorted thinking.
• Get in touch with the child inside of you who felt, and still feels, like a failure.
• Help your inner child see that you were not treated fairly.
• Become aware of achievements related to talents, skills, abilities, and accomplishments.
• Try to see patterns in your failures.
• Once you see the pattern, make a plan to change it.
• Make a blueprint and follow your plan; step by step.
• Involve your loved ones in the process.

With time and work, along with help from a professional if needed, you can break this Lifetrap and gain confidence and self love!!

Reference: Young, J. & Klosko, J. (1994). Reinventing your life. Penguin Books. London, England.

Schema: Self-defeating, core themes or patterns that we keep repeating throughout our lives.

THE DEFECTIVENESS LIFETRAP

The following are signs that the Defectiveness Lifetrap is active:

• Feeling that no one could love you if they really knew you.
• Feeling flawed and defective. Feeling unworthy of love.
• Having secrets you don’t want to share, even with people that are close to you.
• Feeling it was your fault your parents did not love you.
• You hide the real you. You feel the real you is unacceptable. You show a false self.
• Often drawn to people who are critical and reject you.
• Often critical and rejecting to people that care about you.
• You devalue your positive qualities.
• You live with a lot of shame about yourself.
• One of your greatest fears is that your faults will be exposed.

The following is the way this lifetrap may have been developed:

• Someone in your family may have been extremely critical, demeaning, or punitive toward you. You may have been criticized or punished for the way you looked, your behavior, or things you said.
• You had a parent that made you feel like a disappointment.
• One or both parents rejected you or you felt unloved by them.
• You were abused sexually, physically, or emotionally by a family member.
• You were blamed for things that went wrong with your family.
• Your parents told you that you were bad, worthless, or good-for-nothing.
• You were compared to siblings or they were preferred over you.
• One parent left the home and you blamed yourself.

The following are ways of breaking this lifetrap:

• Understand the childhood feelings of shame and defectiveness. Connect with the wounded child.
• Make a list of signs of how you are coping with this lifetrap.
• Try to find healthy coping skills to manage this lifetrap.
• Monitor your feelings of defectiveness and shame.
• List your defects and assets as a child and teenager. The list your current defects and assets.
• Evaluate the seriousness of your current defects.
• Start a program to change the defects.
• Write a letter to your critical parents.
• Try to be more genuine in relationships.
• Accept love from people close to you.
• Stop allowing others to treat you badly.
• If you are critical in a relationship, stop putting the other person down.

With time and work, possibly with a professional if needed, you can break this lifetrap and have more satisfying relationships.

Reference: Young, J. & Klosko, J. (1994). Reinventing your life. Penguin Books. London, England.