• Individuals working in the healthcare professionals may be more likely to experience burnout and compassion fatigue

  • Yoga teacher and author Aggie Stewart explores why this is, and offers advice on implementing much-needed self-care

When it comes to managing work-rest balance, we don’t have to look far to find self-care advice. Whether in the form of tips or suggestions for activities, products, or services, or recommendations on how to eat better, sleep better, love better, relate better, self-care remains a culturally hot topic, particularly within the healthcare professions—and for good reason. The rates of burnout, self-harm, and compassion fatigue are on the rise, not to mention practitioner attrition. For all of its conveniences and amenities, contemporary life carries stresses and expectations that can make helping others regain health and well-being a strain on our own.

Why self-care is important for healthcare professionals 

As holistic practitioners, we tend to see people with complex health needs. Often, chronic stress or current or past traumatic experiences underlie these needs, resulting in multi-dimensional suffering: physical, energetic, mental, emotional, spiritual. As compassionate, empathetic people ourselves, it can be challenging to face the degree of suffering we see on a routine basis without carrying some of it in our minds and hearts. This can have a deleterious effect on our own health and wellbeing, eroding it slowly and subtly over time, making it all the more important that we keep our own health, wellbeing, and capacity for compassion and empathy robust and resilient. Taking care of ourselves, however, is not so simple.

Well before we enter the health professions, we’re counselled to take care of ourselves. Yet this explicit message typically comes with an implicit message: take care of others first, self last. By the time we enter the health professions we often have such an ingrained, unconscious habit of tuning into and meeting the needs of those around us without feeling its cumulative effect, that we can find ourselves stretched, overextended, and drained, realising it only when some aspect of our health and wellbeing breaks down. Perhaps it shows up in our physical health as a chronic health condition, or as persistent fatigue, or increased anxiety or irritation, or decreased mood, enthusiasm, motivation, compassion, or empathy. And when our health on any level starts to break down, it can reinforce a sense of shame or self-blame around not taking better care of ourselves or finding and sustaining a healthier work/rest balance.

Advice and even well-intended education about self-care often translate to additional, separate “to-do’s”. Most of us looking to strike a healthy work/rest balance or to recover depleted health and wellbeing have personal and professional lives already crowded with pressing demands and responsibilities. Adding more to-do’s, even when they are enjoyable and longed-for, may simply not be realistic. Or we may do them for a while only to find that they fall to the weigh side when we’re faced with the needs of others, particularly our clients or patients, the organisations within which we work, or our families.

How to implement self-care and self-compassion

So how do we step out of what feels like a bind so that we can care for ourselves as we care for others?

What if we start by shifting the lens on what we believe self-care to be. What if we began to think of self-care as part of an integrated lifestyle in which our relationship with our self was conscious and as kind and loving as every other intimate relationship we have with those we care for most?

Developing a conscious relationship with our self, one that is kind and loving is aligned with current research on the positive behavioural and health effects of self-compassion. According to this research, self-compassion increases coping skills for dealing with difficult emotional experiences and enables people to thrive and experience less anxiety and depression in the face of challenges. Self-compassionate people tend to show more compassion for others, demonstrating an ability to act on empathic concern while being less likely to experience personal distress in the presence of another’s suffering. At the level of physiology, acting with compassion towards our self, decreases cortisol and increases heart-rate variability, markers of resilience and our ability to regulate emotions through actions such as self-soothing when stressed.

This understanding of self-compassion runs counter to tacit messages we receive both in professional education and training and in the culture at large. Yet, without making it a fundamental quality of our relationship with our self, self-care remains a to-do rather than becoming how we approach living our life to its fullest and most satisfying potential.

Our relationship with our self determines just about everything we do in our day and how we do it. It affects the way we wake in the morning; our morning rituals; what and when we eat; what activities we do; how we interact with others and go about our work; how we schedule our day, our evening rituals; and how we sleep. When we make this relationship conscious, we have a much better chance of making informed and deliberate choices that safeguard our health and well-being while better serving and caring for those around us, whether patients, clients, colleagues, family, friends, or community.

While there are many ways to cultivate a conscious, compassionate relationship with our self, contemplative yogic meditation offers something unique: a practice of self-care designed to support living a meaningful life rooted in a sense of purpose or mission. Linking why, what, and how we practice yoga to what gives our life purpose and meaning shifts it from a “nice-to-do” activity to a quintessential component of sustainable self-care.

Personal yoga practice as quintessential self-care 

Personal yoga practice is exactly what the term implies: yoga practice tailored to our unique needs, interests, and goals. When used synergistically in integrated personal practice, yoga’s robust and highly adaptable methodology and tools such as postural movement, breathing practices, and meditation techniques have a direct impact on the strength and resilience of our nervous system and our energy. Personal practice supports living from a place of mindfulness and clarity and facilitates shifting how we perceive our self and our experience, not least of which is our perception of stressful events, and thus not only our experience of those events but also our response to them. This shift in perspective is self-care in action.

The heart of yoga’s transformative power lies in the concept of sankalpa. According to the yoga teachings, all practice starts with sankalpa, a Sanskrit word variously interpreted as intention, resolve, determination, vow, and commitment. Rather than a one-to-one translations to any of these words, sankalpa carries all of these meanings simultaneously, like a richly faceted jewel. Sankalpa expresses why we practice and helps us identify what and how to practice—that is, which tools and techniques, their order and integration in the practice as a whole, how to adapt or modify them to meet our needs, interests, and goals, and what our attitude toward practice will be.

The meaning of sankalpa also encompasses both a sense of purpose or calling in life and a desire to fulfill or follow this calling. This aspect of sankalpa encourages us to link what we do in practice to how we understand our life’s purpose or mission. It makes practice directly relevant to that purpose while aligning it with our values, other aspects of our personality, and the choices we make on a moment-to-moment basis in all areas of our life. Making this link conscious, elevates the purpose of the practice and strengthens our motivation to do it.

Understanding our life’s purpose or mission requires thoughtful, compassionate inquiry and self-reflection. Here are some questions that can be used as a springboard to this inner exploration:

  • From your earliest memories to the present, what draws your attention, interest, curiosity? What fills you with joy, wonder, fascination, awe, and delight? Think in terms of people, places, activities (physical, mental, emotional, creative, spiritual), and subjects.
  • When do you experience living in harmony with life? Where are you? Who, if anyone, is present? What you are doing?
  • When do you experience a vibrant sense of aliveness, a sense that you and whatever you are engaged with are one and that the engagement is effortless?
  • When you are relaxed and at ease, what do you most long for? What does your heart call out for?
  • What feels unfinished or not fully explored in your life?

Consider journaling or drawing about you reflections to enhance this inward look. I’m always surprised by the subtle detail and insight that arises from putting thoughts and reflections on paper. Reflection could also take the form of contemplation as you walk somewhere in nature, or in a conversation with a trusted friend, teacher, or mentor.

Looking back on your reflections, what patterns do you notice in what draws you? What patterns do you notice in situations in which you feel most in harmony and enlivened by life? How does what you notice reveal a sense of purpose or direction?

The intention component of sankalpa has several aspects. One has to do with the frequency of practice we can reasonably and realistically commit to. Another has to do with how we will practice—that is, the quality of our attention and what our attitude towards our self will be as we practice. For example, if we get distracted easily we might commit to staying present, or if we tend to be hard on our self, we might commit to noticing when we have negative self-judgments. This aspect of intention helps us cultivate loving kindness and acceptance towards our self.

Then there is the aspect of intention that helps us develop inner strengths by drawing out qualities or attributes that help us stay on course with our life’s purpose or mission. This aspect of intention acts as the rudder of a boat that keeps us moving in the direction we need to go. For example, this may be a quality we know we have that recedes when we’re under pressure, such as understanding and acceptance. Or, it might be something that we don’t believe we have within us or that we feel challenged to bring forth, such as self-confidence or leadership.

Each aspect of sankalpa may shift and change over time for a variety of reasons, such as changing life circumstances or personal growth as a result of practice. Welcome this as a sign that sankalpa is doing what it’s designed to do: keep us on track to live with purpose and meaning while developing our potential and supporting our health and wellbeing through a yoga practice that is flexible and adaptable to our needs, interests, and goals.

Aggie Stewart's book,Yoga as Self-Care for Healthcare Practitioners, is available now:

Further reading

What is compassion fatigue?

What's the downside to empathy?

Self-care when you feel overwhelmed

How Yin yoga supports my therapy