Self-care for Medical Students: Reflection by Niamh Kelly

Introduction

I choose the self-care module this term as the title stood out among all the ‘usual’ module choices.  While reading the abstract for the module the keywords ‘body awareness’, ‘holistic health’ and emotions/feelings’ struck a chord with me as I have always strived to understand more about myself and feel that self-care is something I could always improve on.

During the introduction day I defined self-care as ‘feeling good about oneself’, ‘relieving stress, worries and anxiety’ and ‘having a positive mental attitude’.  All of which I believe are important, however, my understanding of the meaning self-care has changed to encompass something much deeper and more fulfilling than these statements.  From a young age I have had some level of understanding about self-care which I feel that I have obtained through education at school and at home.  For example, I have always eaten well, maintained a moderate level of exercise and knew the importance of a good night’s sleep.  I therefore rated my current level of self-care at 6/10. However, having engaged in a self-care module I realise that my current level of self-care falls far short of this value and I am using this experience as a stepping stone to live and practice self-care.  I was shocked to learn on the first day that 1 in 2 GPS in the UK show features of burn out and realised that one day this could be me.  It seems completely unrealistic to think that a doctor who is not fully self-caring and self-loving can deliver true care to patients.  It is clear to me that we must begin with ourselves and learn how to be fully nurturing and loving before entering a world where we strive to deliver the best care we can for others.

Observations

Over the first week I practiced listening to my body and tuning into what it was really feeling.  I have noted even from before starting this course that I have an addiction to caffeine, sugar and bread and so I decided to experiment with myself in the first week and live without these.  I have often used these types of food as a reward or ‘treat’ for achieving targets.

Diet

The biggest sacrifice for me was caffeine- not only do I enjoy the taste but I love the uplifting feeling it gives you and the ‘kick’ it delivers.  Thankfully I do like herbal teas so I used these as a replacement for my usual cup of tea or coffee in the mornings and throughout the day.  It wasn’t long before I felt terrible and suffered from dull, unrelenting headaches a few days after not having any caffeine.  Being my usual medically orientated self I tried to explain the headache by some other logical explanation, until I accepted the obvious fact that I was experiencing withdrawal from caffeine.  I was shocked that a substance such as caffeine could make my body feel this way and knew that it could not be healthy for me.  We don’t always need research to prove something is bad for us; if we listened to our bodies we have all the evidence we need.

In class we had discussed the vicious cycle we can enter with caffeine; a concept that had never crossed my mind.  We drink caffeine during the day and get a poor night’s sleep.  Waking up the next day unrefreshed we rely on more caffeine to get us through the day- not having let our bodies achieve the full amount of rest it needs, and so the cycle continues.  This leads to the depletion of energy.  This made a lot of sense to me and I experienced this first hand in the second week.  I went for a coffee with a friend late in the evening; not because my body wanted the caffeine but to please my friend.  Although I enjoyed the coffee, I suffered the consequence of not being able to sleep that night and having a very unproductive following day. This had a knock on effect on me throughout the entire week and my reliance on caffeine increased.    

I lasted from Monday until Thursday without bread, benefitting from the lighter feeling that I had particularly after lunchtime, when I usually felt bloated and heavy after a sandwich or roll.  On Friday however, I went for lunch with a friend and had bread with my soup.  My body felt heavy and full and I felt ‘wiped out’ after this meal.  Doing a debate on the effects of wheat on the body helped to   confirm why my body felt this way after eating bread.  

Surprisingly sugar wasn’t as hard to cut out of my diet.  My usual craving for a sugary treat after dinner soon disappeared as I actually listened to my body and knew I was full.  An understanding behind why I enjoyed that sugary treat may lie in the fact that I stay up too late and my body gets tired and needs fuel to stay awake.

When preparing a meal I now think ‘what am I eating, why and how am I preparing it’.  

Self-care tools

I used ‘stop, connect’ feel’ when I was driving or just sitting doing work.  On several occasions I felt that my body was tense, especially my shoulders.  I also became aware that I was clenching my stomach in very tight.  By using this tool I was able to recognise these things and relax my body.  My favourite tool to use during the day is ‘conscious presence’. I understand the need for this mind- body connection in terms of the depletion of energy that occurs when our minds are elsewhere.  It was surprisingly difficult to use this tool even during simple tasks such as brushing my teeth or in the shower as I find myself relentlessly planning ahead or dwelling on the past.  It worked best when I was walking and I actually got a sense of happiness and I felt centred.  I understand that by using this on a day to day basis, we can remain fully present throughout the day in confidence. 

Self-talk

I have noted that my self-talk has been negative; something that I have struggled with for a long time.  I am my own worst enemy and tend to have a critical and judgemental inner voice that says things like, ‘You’re lazy, unmotivated and not confident enough’.  I know that my negative self-talk comes from things which I have experienced in the past including failed family relationships and a family bereavement that has made me look at myself in a different light.  Realising that I am love and that I deserve to be loved will help me connect back to myself and to accept who I am in light of my past experiences.   

Challenges

I find that my challenges lie mostly in what other people think of me and the choices that I make.  I have come to realise that this comes from a lack of acceptance of myself and perhaps the lack of connection with my inner self.  For example, I often drink on nights out purely to be in with the crowd.  I also eat unhealthier if other people are indulging in treats such as chocolate.  I find it harder to make self-loving choices particularly about food when I am at home at the weekends.  Here, mum has bought plenty of bread and chocolate that is easy to access in a moment of weakness. Whereas, when I am living in Belfast I choose not to buy these things and therefore find it a lot easier to resist.  Another challenge that I face is my daily emotions.  I can be overcome at times with sadness and worry if other people think that I am a negative person.  I believe that I need to accept the past and allow myself to feel rather than think all of the time. 

Class

Surprisingly, I enjoyed the creative session the most in this module.  My initial reaction to this session was a feeling of dread and pessimism.  I have always felt like an ‘uncreative person’ and I was afraid of being embarrassed. However, I enjoyed making my collage of happy times and found it therapeutic and it brought me back to being a child again when I used to love doing arts and crafts.  I realised that I am open to try something different and was able to appreciate everyone and not compare myself.  My self-talk following this day was positive. 

The debate on alcohol highlighted for me how bad it actually is. ‘We only need one hangover to know alcohol is bad for us’.  This statement has stayed with me and reminds me that alcohol is something I should try my best to avoid.  I also enjoyed learning how the environment can influence our long-term health and enjoyed researching the ACE study.  I was not completely unaware that such things can affect health however; I have a greater understanding and awareness of this now.

Conclusion

This course has been an eye opener in terms of how important it is to love oneself and to live in a way that is nurturing and self-loving.  I understand the importance of trying to connect with our inner self and to remain present in everyday life to reduce the depletion of energy that this brings.  I plan to continue to practice and live the tools and techniques that I have gained in this module and ultimately be able to deliver the same quality of care to patients that I give to myself.