Everybody needs self care at some point, not just people with PTSD and their caregivers. Self care is not one size fits all. This article describes an established tool for assessing and planning self care. The method is a guide and tries to be flexible, but this is only one way to keep yourself healthy. It’s entirely possible to take good care of yourself without the wheel and the questionnaire. Or you can do this once, learn from it and move on.
The Self-Care Wheel is a representation of the various of aspects of self care, which are psychological, emotional, spiritual, personal, professional, and physical self care. The wheel is intended to be used to assess and plan self care, not for identifying personal preferences. To be fully healthy, all aspects need to be nurtured.
There are three steps in using the wheel.
- Assess your current self-care
- Create a self-care plan.
- Act on the plan.
Step 1. Assess
At the heart of the wheel is the Self-Care Assessment Worksheet from Transforming the Pain: A Workbook on Vicarious Traumatization by Laurie Anne Pearlman and Karen W. Saakvitne. The assessment consists of a series of questions about your current self-care practices in each of the six aspects. For each practice, you score whether you do it well, barely do this, or if it never occurs to you to do it.
Example: We previously reviewed Roméo Dallaire’s memoir about PTSD, so we can use him as an example here. He sustained his original operational stress injury in Rwanda, which became PTSD through lack of self care and appropriate treatment. In the book, he writes about how poorly he looked after himself and at the same time pushed himself relentlessly at work to look after CAF personnel.
Dallaire wrote in “Waiting for First Light,”
Going full steam at all hours was what had kept me alive in Rwanda and it felt like it was keeping me alive now. I’ve always had an extreme work ethic, but now I was stretching that beyond all reason, taking on more and more projects…
I was not sleeping or taking care of myself. I was not exercising. For thirty years, I had done physical training every day, but after Rwanda, I had lost the will. It was as though I had no compulsion to do anything healthy or positive. for myself.
I had lost a lot of weight in Africa. My body was weak from lack of nourishment, but it was also just worn down. Now I found myself cramming down two or three hamburgers, fries, sodas, chocolate bars, until I could feel the pain of my straining stomach.
Based on his writing, here is how I would assess his Physical Self Care. (This is based entirely on a reading of the book. I have no other special insight or knowledge. I have no idea whether he’s ever done a self-care assessment.)
He doesn’t sleep well or exercise. His eating patterns vary significantly. When he is working hard, he barely eats. But late at night, he eats too much fast food and drinks too much.
Step 2. Plan
Based on what you find in the assessment, make a plan to look after the self-care aspects that are in need of attention. Plan some activities to take care of the shortfall in the coming days. Make use of the practices that you don’t normally use.
Example: Now that we know that Dallaire’s Physical Self-Care needs work, he can plan to address this. Prior to Rwanda, he worked out regularly. This would be an easy thing to add back in. He could join PT on a military base, hire a trainer, or find a workout buddy.
I picked exercise for Dallaire because fitness is an important part of being a soldier. I didn’t think he’d be sympathetic to massages or eating salad. One of the insidious things are PTSD and many other mental health issues is a feeling of lack of self worth. People with PTSD are often highly resistant to the idea that they need, deserve, or have room for self care. Later when these same people become caregivers or peer supporters, it is still an ongoing struggle to achieve an appropriate level of self care.
3. Act
The final step is to make sure the plan is executed. Planning is easy compared to actually doing. There are a few strategies that can help.
- Schedule your self-care activities and be specific. Write them in your calendar or day book.
- Make a commitment to yourself. Remind yourself that you need to look after yourself before you can look after others. Affirm that you are worthy of self care.
- Share your plan. If you tell someone else about your plan, you are more likely to follow through.
Fundamentally, self care is about making sure that you are healthy in all aspects. The wheel is a tool to help you look after yourself, not setting yourself up for failure. Don’t beat yourself up, if you slip. Self care is a work in progress.
How about you? How do you know when you need self care? What are your favourite self-care practices?