Too much and also not enough

Today’s theme is: nothing would be enough.

Something I’ve learned about the physical process of dying is that it can take a long time. And during that in between time, when someone is slowly slipping away, there isn’t a whole lot to do. Family members ask me all the time what they should be doing, besides medicating and sitting and doing the personal care that a living/dying body still requires. And all I can tell them is, what you are doing is enough. There is no secret other task to complete; you’re already doing everything you can. Lately I’ve learned to add, it doesn’t feel like enough, but nothing would. Nothing would be enough.

Extrapolate that thought to the situation we all find ourselves in: the seemingly endless marathon of work and childcare and eldercare and anxiety and boredom and news and sickness and and and. Nothing we are doing feels like it is Enough: there are not enough hours in the day, not enough mental space to hold all the events of the world, not enough self care, not enough socialization, not enough of anything. And yet, what could be enough at this moment? What would be enough, except to return to our normal lives?

So much of my work is giving permission to others to let go. I have leaned over the bed of a dying body and whispered that it’s time to go. I have sat in intimate silence with near strangers and assured them that it is not cruel, but loving, to want their loved one to die instead of live in suffering. I have encouraged both the dying and then the bereaved that what they are doing is enough, even though it doesn’t feel that way. I have said it in supervision, to social workers who feel they should be smarter, more skilled, better advocates. I have meant these words every single time. But I find myself forgetting to apply them to myself.

I could make you a list of all the times over the past ten months—the past ten years, really, of my career!—that I have felt I did not do enough. I think any social worker could list for you the mistakes they’ve made over a long career: resources they did not know about, clients they could not reach, tasks they forgot to complete. But I would also argue that what has gone undone is far, far less than what has been done: referrals made, clients heard and supported, minds changed. Even when we feel that there is not enough—not enough resources, not enough time, not enough of us—we continue to do the work.

And so I give you permission—who am I kidding, I give myself permission—to let go of doing more. There is no more; there is what we are doing and it is enough.

Burning out, taking care

I don’t want to write about burnout.

I don’t want to write about self care.

I don’t want to reiterate and review what we all understand, not only as social workers but as parents trying to maintain some normalcy for our children; as professionals attempting to be effective and innovative with new work challenges; as adults navigating how to safely socialize with our loved ones. I don’t want to acknowledge that I have hit a wall because we are six months into a global pandemic and in the midst a political horror show and I have two little kids and three jobs and it’s honestly just too much.

The thing is, it’s not hard to write about burnout and self care: they have become meme-ified and pop cultured to death. There are articles and BuzzFeed lists and Tik Toks (I would imagine; I’m too old for Tik Tok) that explore these topics. But because the internet eventually blunts the edges of nuance from anything, these concepts feel more like buzz words than complicated and fraught issues. But there is nuance to be found. There are levels of burnout; there are different forms it takes, different ways it manifests, not just in our professional lives but in our personal lives. There are ways to talk about self care, too, that are complicated, that force us to consider the complicated nature of society and privilege, that go beyond “make sure you’re getting your 8 hours of sleep a night!” There may be nothing new, exactly, for me to say about burnout and self care, but here I am. Again.

I am tired. I am tired of a pandemic that has robbed me of the most basic joys of my life: overscheduling our weekends with out of town visits and parties and tertiary friends. I am tired of a political discourse that is disappointing at best and disgusting at worst. I am tired of a scary and unknown future that awaits us with climate change and racial violence and injustice. I am tired of the news, every day, of people in power doing the objectively wrong thing. I am tired of checking off the box on my psychosocial assessment that says I provided education about self care to the patient and their family. Did I do that? Did the words ring hollow? They ring hollow in my own mind so I imagine they aren’t coming across full of vitality and assuredness.

I am sleeping; I am eating; I am exercising (kind of; running up the stairs twenty times a day counts, right?). I am doing the self care things but I am still in the burnout place. That’s why I keep returning to these concepts. It is not as easy as saying “treat yourself” and getting a pumpkin coffee. Self care is complicated and difficult because the majority of us cannot just turn off. In fact, I know I’m luckier than most. I can’t write about self care and burnout without also acknowledging my great privilege. When I am exhausted, I have a partner who can pick up the home and kid slack. Although I am enraged by the lack of justice for my Black brothers and sisters who have been murdered by police, my whiteness allows me to be only angry, not traumatized. When I have reached my limit at work, I can schedule an easy day or call out sick. But I am still struggling.True self care does not feel possible in this environment. I keep thinking to myself, there is a way to be restored. But what is it? How do I find it?

This is the part where I should review the signs of burnout and tell you some of my favorite self care tips. But I don’t think that’s what we’ll do today. Instead, I want to thank you for reading; I feel better after the words are out of my head and released into the world. And I want to say, too, that I think it’s ok to hit the wall once in awhile. Sometimes doing the best you can is to let go of the best and just, you know, do.

Be well this week; I’m certainly trying to be and I hope you are as well.

Swinging back and forth

Well, things have taken quite a turn, haven’t they?

I don’t have any special answers, any more than anyone does. I’m doing what everyone is: trying to balance childcare and work and self-care and watching the news (though I do less of that because self-care). I’m providing supervision and some therapy virtually; I’m seeing hospice patients in their homes, wearing a mask and sitting several feet away. I’m trying to provide some structure for my little girls, who are really too young to have a grasp of what’s happening but who still need reassurance after their lives have been changed significantly. I am video chatting with friends and family and having the occasional crying jag. I’m doing what we’re all doing. And in the midst of it, I am grieving.

I’m sure you’ve seen a lot about grief in the past few weeks. It seems to be the best descriptor a lot of people have about how they’re feeling. In addition to the anxiety and stress and depression many of us are experiencing is a heavy helping of grief: for the normalcy we’ve lost, for the suffering of others, for the waves of deaths around the world. We are all experiencing loss.

I have a favorite theory of grief. (If you’re a social worker reading this, or a hospice worker, I know you just nodded your head in understanding. If you’re not, I’m sure this blog is already a weird read for you so you shouldn’t be too surprised). In the past few weeks, as we’re all trying to come to terms with what’s happening, I’ve found this favorite theory to be a great comfort. It’s called dual process theory and I hope you find it helpful, too.

Imagine a pendulum swinging between two orientations: loss and restoration. When the pendulum swings into loss-oriented thinking, that’s when we’re actively grieving: experiencing our pain, adjusting to the “new normal” (a phrase I have grown to truly despise), and accepting our losses. We can only live in that space for so long though; it’s sad there and our brains can only tolerate so much sadness. So imagine the pendulum swinging again, this time to the restoration orientation. This is a state where we’re becoming comfortable in our new roles, being distracted by other needs, and paying attention to the ways in which our lives have changed rather than just our losses.

It’s not a linear theory; that’s part of its appeal, if you ask me. Instead it imagines the pendulum swinging back and forth over time, as we experience both states of being. There’s no timeline for grief, you see. There’s no normal way to do it. We’re all just swinging back and forth between the mundane tasks of daily living and the profound grief we are experiencing as human beings in the midst of an unprecedented crisis.

I hope you’re caring for yourself, however that looks. I hope this theory or this blog is helpful to you, or to someone you love. I hope that you are able to see the light that shines in darkness and that you can forgive yourself when you’re not able to; it is, after all, an ongoing process. I hope you are safe. I hope this ends soon. I hope you I hope and hope and hope.

Be my witness

I’ve had a lot of trouble writing this post. Not because I don’t know what I want to say; the words have been pouring out for days. It’s more that I can’t seem to get them into a coherent order. I’ve been struggling with my work—not my job, but the actual work of being with grief and illness and death. I’ve been thinking for weeks about what it means to witness the suffering of others.

It’s a heavy topic, and I’ve come to imagine it as an actual weight. When I’m with my patients and their families, I take their weight for a little while, to give them a rest. Then I hand it back before I leave the house. I literally leave, which helps separate me from the grief I’ve witnessed. But lately the weight has seemed heavier, not as easy to release when the visit ends. And because this blog has become a key part of my self-care, I’ve got to write it out so I can move on.

The other day, I mentioned to my husband that I had met someone who had lived the life of Job. He had never heard that expression before, which makes me think it’s an old-fashioned one (I have an old soul, you guys) so I will elaborate. Skip this paragraph if you’re familiar with our friend Job of Old Testament fame. Job was some poor soul that God used to prove a point to Satan. (Old Testament God made some upsetting choices, honestly). God not only stripped Job of his earthly possessions and killed off all ten(!) of his children, He also gave the guy a horrid skin disease. This was all to prove to Satan that Job would continue to love God under any circumstances. There are more details, of course, but you get the gist: Job’s suffering was incredible.

I sometimes meet people who have suffered so much that a part of my brain thinks, this cannot possibly be true. Their losses have added up so significantly that it is almost unbelievable that one person could have bad luck like that. There are times that I am faced with such tragedy and pain that it nearly takes my breath away. In those moments, I wish I didn’t choose to be a witness to suffering.

And yet, I did. Or it chose me, whichever. The point is, I am honored that people trust me enough to tell me about their trauma. I feel that it is a gift that I can bear witness to someone else’s pain and briefly hold it for them so they can get a break. I don’t have to live with it, myself (I have my own tragedies to carry). Anything is bearable for a few minutes and I usually can let it go.

But, like I said, lately I’m having trouble releasing the weight. I imagine myself being pushed down, little by little, as I hear sadder and sadder stories. Picture me up to my knees in the ground, carrying something heavy on my shoulders. That’s what it feels like: I’m standing upright but I’m sinking.

It’s hard to admit that. I pride myself on having excellent boundaries and solid self-care. It’s difficult to tell you that my usual stuff is not totally working at the moment. But the best disinfectant is sunlight; it’s better to admit that I’m struggling. So what will I do? In these times, which come along with the territory of the work, I allow myself to feel overburdened. I let my heart feel heavy. I go to church. I look into the beautiful, healthy faces of my daughters and try to be present with them. I read celebrity gossip. I take deep breaths. And I wait, as patiently as I can, for the weight to lift.

There is great tragedy in the world but also great joy. Even Job received his rewards (questionable whether the pain was worth it, but again, Old Testament stories are wild). I can still see the good. It exists in the warmth of strangers, in music, in bright sunsets, in my children’s laughter. It exists in my work, which can be deeply, profoundly sad, but also wildly, touchingly beautiful. It is heavy but I have chosen to carry it. I am still grateful.

Speaking of which, thank you for being my witness today. I hope you find an easy road today. Be well.

The gift of the work

I started off my day already over it. Yesterday only one of my five scheduled patients bothered to show up. This day was starting with a patient I had seen a year ago who told me the exact same story she was telling the first time we met. This was followed by another no-show and yet another frequent flyer patient who never wants to do anything to change. Overall, I was ready to leave the building.

My last scheduled appointment was a lady who didn’t really want to see me. Her son had cajoled her into coming and she went along with it because she’s a mother and sometimes we do things we don’t want to do. Granted, this woman’s son is in his 60s but still: you never stop being a mom. And your kids never stop wanting you to be well.

Still. This lady wanted no part of it. And I really couldn’t blame her. She’s depressed because she’s basically just waiting to die. She’s had a lot of loss, more than her fair share, as she says. And for awhile we just sat there staring at each other because she didn’t know what I could do for her. “Nothing’s going to change,” she kept saying. “What’s the point of talking about it?”

I was mentally cursing her son for not hearing his mother clearly say she didn’t want to come when suddenly something did change: she started to talk. We talked about what it means to get older, how much loss there is and how lonely it is. She talked about how even in her depression, she’s content with her life. She talked about the child and husband she’s had to bury and how she’s kept those losses tucked away in a little box that she hides from the outside world because she doesn’t want to disturb them. Then she talked about climbing trees when she was a little girl. She smiled. I did too. She said she’d think about coming back.

The rest of the day shifted in my mind. It’s been a long week and I was feeling useless and out of my depth and frustrated. I could hear myself being impatient with my other patients, wanting to rush them out of the office because I didn’t know what they wanted from me. I know what burnout looks like and I could see myself gliding towards the flames. This lovely lady brought me back, just by opening up a little bit and allowing me to listen.

Now I’m not saying that we should rely on our patients to keep us engaged and upbeat about our work. But I also can’t deny that success with one patient at the right time can make a world of difference. It is, I think, what keeps us in the work: watching people be helped, even just for a moment, and knowing that we are the helpers.

I’m also not denying that I’m nearing a burnout point; it’s time for a vacation, clearly. But I am relieved to know that I haven’t completely checked out. This is another gift of this work: the reminders that come from the grace of others, in letting us bear witness to their pain, even though we don’t have any magic answers. How lucky for me that this lady came along today, to remind me.

Photo by Leone Venter on Unsplash

The wave of grief

My referrals seem to come in waves: one month it will be folks who need help managing their diabetes; the next will be a wave of young patients with anxiety. This is only anecdotal evidence of course, but it was like this in hospice too: you begin to notice some trends. This particular month, it’s grief.

I’m quick to say I lead a blessed life, but it has not been without great losses. My mom died three and a half years ago when I was pregnant with my older daughter. It was a terrible time, of course, but her death was not unexpected. In some ways it was a relief; she suffered for a long time. And since I was pregnant with a very wanted baby, there was a lot of joy intertwined with my devastating loss. When she first died, I still worked in hospice and I found that I was able to use my grief to help patients. Not every day of course, but sometimes the conversation opened the door to self-disclosure and it felt both clinically appropriate and personally beneficial.

More time has made it both easier and harder. Lately, the patients I’m seeing who are struggling with their grief are focused on how much time has passed. “It’s been two years,” one told me, “I should be better.” Should is a useless word, especially when it comes to how we feel. I describe grief to those patients as ocean waves: you can be standing at the shore for a long time and not notice them. Then suddenly one knocks you over without any warning. I know this as a clinician and I know it as a daughter without a mother, but still. Still. My own grief sometimes sits on my chest like a weight, making my breathing a little shallower. There is a pricking feeling behind my eyes that signals tears. In those moments, I am afraid that I won’t be able to hide it. I haven’t lost it yet but recently I have felt very close.

This is grief, I remind myself. This is a big ocean wave. This is because I had a baby recenty and my 3 year old only knows my mom through pictures and because the holidays just passed and because now that I’m a mother, I understand her so much better but I can’t tell her that and because… Because. This is grief.

The question now is, what will I do with it? I’ve been guarding it like a secret but I know that sunlight is the best disinfectant. So here I am, bringing it into the light: I’m having a hard time. Now I’m going to be mindful and intentional and not let myself be swallowed whole. Self-care is sometimes stepping back and being well. And the occasional afternoon hot chocolate. I learned that one from my mom.

The body knows

I had a tricky interaction with a patient a couple of weeks ago. A patient of mine (who has an extensive trauma history) made some comments about my children not being safe in daycare. She knows I have kids because she asked once and it’s such an innocuous question, I didn’t even think about answering it. In fact, I don’t generally have strong feelings around self-disclosure; sometimes I think it can be helpful to build rapport and trust so I don’t worry about answering mild questions from patients. This is all to say, I had no problem with this particular patient knowing a little personal information about me. That is, until she hit me with this nonsense about my kids being in danger because I’m not at home with them full-time. This is a touchy subject for me, because it’s a deeply personal choice that has several variables and the judgement around it feels absurdly sexist. When she said that I should be careful, that bad things could happen to them because they’re with strangers most of the day, I had to work very hard to be still and not let my face betray my internal, white-hot rage.

In the actual moment, it passed fairly quickly. I squashed it down and told myself that this woman thought she was being helpful; she wasn’t intentionally being cruel. (She even told me that she was being grandmotherly with her concern. Ok, lady). It was later, when I brought it up in supervision, that I realized just how very upset it made me. Telling my co-workers about the experience, my hands started to shake; I felt my breath quicken and my face get hot. And I realized, I was still really worked up about those few minutes!

It got me thinking about how we listen (or don’t) to our bodies when we’re working. I’ve written before about working with frustrating patients and suddenly becoming aware that my shoulders are up by my ears and my fists are clenched. How does it sneak up on me? Because I’m not really paying attention to my own body. There’s a lot we have to do when we’re with clients: listen actively, reflect back, read their body language, etc. But we also have to listen to what our bodies are telling us; often we react physically before we’re able to name what we’re feeling.

Personally, I especially struggle with being in touch with my physical self when I’m uncomfortable with the energy in the room. Give me someone on a crying jag any day; I can sit with that heaviness and have no problem being in my body: breathing deeply, being still, creating a space for vulnerability. But when a patient touches a nerve (usually unknowingly), my fear or discomfort or anger arrive first in my body, try though I may to ignore those feelings. In those moments, I’m trying so hard to reserve judgement and be still and present that I ignore the warning signals that I’m about to emotionally check out. When I feel my toes curl in my shoes and my hands grip the sides of my chair, it’s usually a sign that I’m not going to be at my best, clinically. In those moments, I have to recenter: I take deep breaths; I practice stillness. Then I take my ass to supervision, because clearly I have some things to work out!

The body knows; we do better when we remember that and listen to what we’re being told: to slow down, to reflect, to breathe. And to utilize supervision!

Crispy around the edges: Avoiding and recognizing the dreaded burnout

I have started this post about burnout about five different times. I'm having a hard time figuring out where to begin, partly because I've been considering burnout since before I even became a social worker. In fact, I sort of decided to become a social worker because I read an article about burnout when I was fifteen years old. Seriously.

The internet was such a new thing when I was in high school that an offered elective was something called "Electronic Fiction." For real. The basic point of the class was to look things up online and write about them. (This seems hilarious now but it was the late 90s!) One of our assignments was to pick a future career (a daunting task for a 15 year old, by the way) and do some research about it. I took this task way too seriously. In fact, I distinctly remember a classmate telling me it was just an assignment; I didn't have to make a lifetime decision in that moment. But apparently that was lost on me; I had to decide right that second what I wanted to be when I grew up. I put a lot of consideration into what kind of work would appeal to me. As I mentioned last week, doctoring was not for me; too much science. Professional acting seemed good but, you know, really hard. My teacher asked me what I thought I liked doing and I said, earnestly and honestly, "I like to help people." She told me to look up social worker.

It is very telling that the first article I came across after I searched (I swear this class was even pre-Google, I think I used Lycos) was an article about burnout. I was immediately drawn to this concept. It hadn't occurred to me that doing something good could make you feel bad. I was enthralled by this article. I printed it out and highlighted it. It stayed in my mind for years. And so, I started my social work career thinking I had all the tools to combat burnout. I read an article when I was 15! I'm ready!

There are many ways to combat burnout. Blind optimism is not enough, it turns out.

Part of the reason burnout creeps in, despite the walls we build as professionals to keep it out, is that it's systemic. As social workers, we work within systems that are lacking: lacking in funding, in staff, in resources. We spend a lot of time, no matter if we work in a big health system or for a small non-profit, struggling against a system that mostly says no. That is exhausting.

Add on to that the stresses of bearing the weight of other people's struggles. It is virtually impossible to spend all of your working day listening to people explore loss and pain and sadness without starting to feel like you have heard enough. I can always tell that I'm getting crispy around the edges when other people's emotional pain starts to seem... irritating. Like, I get it, you're sad. I am always startled when I have that thought but when I do, it's an eye opener: I am tired. I need a break.

Breaks are good! They are a vital part of preventing burnout and recovering from the stress of this very difficult work. But if you don't have any precious vacation time right this second, there are other options. You can Google (we've come a long way from Lycos, guys) tons of lists and articles about how to avoid burnout. What follows are some of my favorite tips.

One is to have a real life. I've been asked many times over the years how I do this job and one answer is that I have created a beautiful life outside of work for myself. I learned how to cook (do not listen to my old roommates about my culinary abilities, please. I've gotten much better!); I have lovely friends who live all over the place and are happy to have weekend visitors; I like to read and still go to the library to borrow books. There are lots of ways I spend my time that have nothing to do with social work. 

Burnout needs to be combatted at work as well. To that end, another invaluable way of keeping yourself sane is having a work best friend. It is imperative that you have someone at work you can call or someone whose office door you can close and say, "holy shit, this day." Having a partner you can share your frustrations and successes with is key. When I worked in hospice, I did a lot of joint visits with nurses and developed some great friendships. They helped me feel less isolated when I was driving all over creation. I also appointed myself as the social chair of the social workers and demanded monthly happy hours. Amazingly, this worked, and a good sized group of us got together monthly over drinks. We even managed to talk about stuff besides work a lot of the time! Thus I managed to combine having a life with having work friends. 

Finally, another very important tool to combat burnout (and also the whole point of this blog): supervision. Sometimes we don't have the answers, especially when it comes to ourselves. We can't see what's holding us back with a particular client or why we're so frustrated with our work. It takes the objectivity of a supervisor combined with a good working relationship to help us clarify not just cases but our own feelings and struggles at work. Something I've always valued in supervision is having someone say to me, "Yes. These are valid feelings. You are entitled to them. Now what can we do with them?"

There are so many articles like this blog post, that give you advice on how to avoid, recognize, and address the symptoms of burnout. I added to them because I believe it's important to keep talking about it. But the fact of the matter is, you have to find the tools that work for you. And you have to do that work so that you can survive doing this work. Take care; it's the best thing you can do for yourself and for your clients.

On to the next

Today is my last day as a hospice social worker. I have done this work for more than five years. In those five years I have gotten married, bought a house, struggled with infertility, lost my mom, had a baby, and suffered a miscarriage.  Throughout experiencing all those joys and losses, I have had a team at work that has supported me like a member of their family. They threw me a baby shower; they came to my mom’s funeral; they arrived with food when I had a newborn and barely knew what time it was. They have listened (and listened and listened) as I have talked (and talked and talked) through my joy and my grief, all the while helping me to see how I could continue to do this work.

This heavy and rewarding work. What is there to say about it that will capture the complexity of the last five years? It’s hard, of course, but also more full of joy than I imagined when I started. I have been so blessed by this experience, by the opportunity to meet people facing the unknown and help to bring them a little peace. I have also been frustrated, tearful, anxious, troubled, and stressed out. I have been lucky that those feelings have been balanced by gratitude; by the kindness I have been privileged to witness; by the team I have worked alongside; and by the families I have been privileged to follow. When the balance between gratitude and stress started to tip too far in the wrong direction, I knew it was time to move forward.

I’ll continue writing and reflecting on my experiences in my new role as a behavioral health consultant. I hope you’ll continue reading. This blog has become part of my self-care routine in a way I did not expect and your comments and kindness keep me moving. Thank you, dear reader, for joining me. On to the next!

Photo by Kira auf der Heide on Unsplash

In Defense of Good Enough

I know how the title of this one sounds but I stand by it. Good enough is good enough.

I think I speak for the majority of us when I say that we put an enormous amount of pressure on ourselves in this field. We became social workers to help people, to fix their problems, to change the world. We can chant “meet the client where they are” a hundred times a day but deep inside there remains a voice that says, “you can fix this!” There is for me, at least. I’m seven years post-Master’s and there are still times that I forget that my goal is not to fix other people’s problems. My goal is to light the way on someone’s path, not lead it. Still, I have patients ask me all the time, “what should I do? What do you suggest?” Those questions put me on edge because I often don’t know the answer. That doesn’t make me a failure, though. It makes me human.

Part of being human means I have my own stuff to work through. There are days when I find my mind wandering in a patient’s house: did I call the air conditioning guy? When will I go to the grocery store? How am I going to get to my next visit on time? In those moments, I have to pull myself back and refocus on the person in front of me. Sometimes that’s hard to do.

Photo by thr3 eyes on Unsplash

When I was on maternity leave and preparing to come back to work, I spoke with a therapist about how I could continue my work. I felt I had a newfound sense of empathy after having a baby but also a newfound sense that nothing else mattered. I feared that a part of my mind would always be preoccupied with thoughts of my daughter: was she eating, sleeping, crying, did she need me? How could I ever be fully emotionally present at work again? The therapist told me, “You will be better at your job and you will also struggle. And that’s ok. You have to accept not being at your best for a while but being good enough.”

I think about that all the time. There are any number of reasons we aren’t on our A game at all times: big milestones, like having a baby or getting married, but also small ones, like an upcoming vacation or an argument with a friend. It is impossible to be the best every single day. I imagine people in other careers have off days; why is it so bad for us to have them too?

I know the answer even before you shout it at me: we’re dealing with real people and their emotions. Our patients don’t care if we fought with our partner this morning or if our oil change is overdue. Their immediate world is fraught with illness and family dynamics and anticipatory grief. They do not have the space to take in our shit, quite frankly. We have to leave it at the door and do the best we can.

And on the days that we know our minds wandered, that we were not the most compassionate, the most healing, the most, we have to forgive that in ourselves. An expectation to be perfect is a good way to feel like a failure. So why set ourselves up that way? Good enough really is good enough.

How do you do this work?

I wrote the other day about a common question my patients ask me, namely what I do as a hospice social worker. That post brought to mind another frequently asked question: How do you do it?

My co-workers and I laugh about this. Patients, their families, people at cocktail parties, all respond with a mixture of awe and fear when I (and my co-workers) tell them what we do for work. "You must be such a good person," they sometimes say (which is deeply awkward to respond to graciously, by the way). Or, "Oh, I don't know how you do it, it must be so sad."

And it can be sad, certainly. (My husband tells a great story about my first few weeks as a hospice social worker wherein I came home crying, telling him he can't ever die. It's funnier than it sounds). But, in addition to the sadness, it can also be humbling and joyful and surprising. It is an amazing privilege and honor to be with someone during one of the most intimate parts of their life. 

But, still. The work is hard.

It is also easy to forget how to care for ourselves and not let the sadness of it overwhelm us. I've heard our work described as addictive: there is an adrenaline rush when you are constantly walking into crises. It's easy to get caught up in that rhythm and excitement, making it hard to recognize the need for a break. Self care is one of the most important parts of our practice and also one of the easiest to put to the side. There is a need for many of us to be all things to all people; it's unsustainable.

So what do I do to take care of myself? I take myself out for long lunches and read trashy magazines. I call my work friends to say, "Please listen to this crazy thing that happened." I take my days off and enjoy them. This is my self care. It is both deeply personal and deeply necessary.

Tell me about yours.