Working in an active duty Department of Defense (DoD) Behavioral Health Clinic can be challenging, with busy patient loads, complex cases, limited administrative time, and frequent short notice tasks. It can be a recipe for burnout, and those of us working there are often encouraged to engage in “provider self-care.” Such self-care is intended to be a daily ritual with the hope that doing so will prevent burnout and keep the caregivers healthy and productive. I’m a fan of the daily self-care model. I have an active social life, I regularly engage in my hobbies, I read, I exercise, I have a healthy diet, and even go to yoga. Even with all this text book self-care sometimes tragedy and adversity can crash into the personal lives of the caregiver.
Like many veterans and military members I live far away from my family of origin. My husband and I met when we were stationed together in the Navy and we settled in the location of our last duty station. In my case, that is the opposite side of the country from my family. Normally that is a mild stressor, but when there is a family crisis the distance can multiple the magnitude of the stress, particularly when bad news is delivered via phone. On September 23, 2012 my parents called to tell me that one of our family members had been shot by her husband. Sarah, my cousin, had been shot twice in the lower part of her face and the upper part of her chest by her husband, a Marine stationed at Camp Lejeune, NC. The couple had been arguing and Sarah left the house in the early hours of the morning. While she lay paralyzed in a neighbor’s yard her husband turned the gun on himself. He died on the spot, but Sarah was found alive about an hour later. To say that it is a shock for something like this to happen in your own family is an understatement. There are no sufficient words to describe it. Sarah survived 4 days in the ICU, but ultimately she could not survive her injuries and she died on September 27th.
The day before she died I had realized that I was struggling to stay focused at work and was feeling very distracted by my concerns for my family. However, I had been having a difficult time figuring out how to tell people at work what was going on in my personal life. It was so extraordinary. How do you bring that up as you are waiting for a meeting to start? Do you send an email? What is the proper professional etiquette for this type of personal issue? So I said nothing for several days. When I received the news of her death I was attending an Army Wide Suicide Stand-down, which was warning that suicide could impact all of us, including caregivers (talk about strange timing). At that point I realized I should tell my supervisors and co-workers what had happened. Over the next several days many of them reached out to me and my family to provide support and express their own shock. It was a comfort to realize how much support I could receive from co-workers. But I still felt uncomfortable sharing my personal grief and family matters at work. What I wasn’t sharing openly was that the day my cousin died my mother told me she had been diagnosed with early stage Alzheimer’s. Although I knew she was having memory problems and had been the primary advocate for her to seek testing, this was an emotional blow. Her words were something like, “I don’t want to have this…” Looking back, I worried that if I shared my double dose of bad news people might think I was seeking sympathy or using this as an excuse to get out of work. And yet, I was not working up to my usual standards.
By New Year’s Day I was getting caught up at work and back on track. Then, in mid-January I tripped on a couple of stairs and broke my wrist. It also happened to be my dominate wrist. Friends asked if I was going to take time off from work, but I said, “No. I’m a psychologist I can work without a wrist.” This response failed to take into consideration how much writing psychologist do, and I quickly discovered that I could not type with my arm and thumb in a cast.
I’d say it’s been a difficult year for me. I have learned a humbling lesson in how quickly one can start to fall behind at work and how hard it can be to regain motivation and momentum once the backwards slide begins. Daily self-care for anyone, especially caregivers is a must, but it is not enough. As providers we need to know how to say “I’m having a hard time and I need some extra time or some help.” This can be a role reversal for many behavioral health providers and some of us may not be comfortable in that role or recognize when we are in such a role.
This year has reminded me of what our clients may be experiencing and how difficult acknowledging problems can be for service members and veterans. It’s has also been a reminder that regardless of our professional expertise in helping others, injury, disease, tragedy, and loss can still invade our personal lives rendering us in need of support from others. So with that, I would like to give thanks to my co-workers, friends, and family for all the help and support this year.
Dr. Elizabeth Parins is a Deployment Behavioral Health Psychologist with the Center for Deployment Psychology. She currently works at Madigan Army Medical Center on Joint Base Lewis-McChord in Washington state.