Self-care is crucial for all helping professionals. A good self-care routine helps one avoid burnout and what is sometimes known as “compassion fatigue.” What does self-care look like when the clinician shares the experience of pregnancy loss with a client? Hearing others’ stories repeatedly can create feelings of sadness and stress as the clinician not only cares for herself but for others in the same boat. For the clinician whose loss was more recent, certain stories of loss from clients may trigger her own grief, sadness, or anger.
There is no right or wrong way to take care of yourself. It’s difficult to make suggestions because everyone is different. Common self-care strategies for clinicians include exercise, meditation, yoga, therapy or supervision. Some find comfort in hobbies or time with friends and family. When the loss is recent, clinicians may wish to seek out a supervisor or consultation group in order to remain aware of how their clients’ concerns are affecting them. Clinicians with parallel experiences to clients can easily identify with clients but when they over-identify, they risk making too many assumptions about the client’s experience and risk losing some measure of objectivity (not that we are ever completely objective!).
Self-care needs may change over time. This may be due to several factors. A clinician’s social support network may change as she lets more people in to her experience of loss. The passage of time will sometimes make the pain of loss less acute. Healing can occur in many ways. Noticing what one needs is the key to making the necessary changes in self-care. Clinicians, like their clients, may need extra support on anniversaries of the loss or other important calendar markers.
How does self-care affect one’s ability to be present with pregnancy loss clients? It might be important to point out that I did not begin running loss support groups for 2 years following my loss. I needed to take some time to myself to grieve and heal. In the early days of the support group, I was very much aware that my own healing was a work in progress. Running the group was part of my healing–I could not deny the power of sitting with other individuals who had walked in my shoes despite the limitations of my role as the helping professional. At the same time, I found that it was important to be able to separate my experience at times in order to be an effective therapist and group facilitator.
Initially, I was so careful about my emotional reaction in the room. Now, if I feel sad or the tears flow in reaction to a client’s story, I am not that concerned. I might explain my reaction to the client and how it touches on an aspect of my own experience. Being authentic in the room is important to me and I think my clients feel less alone when they see that others are moved by their stories.
What did I actually do for self-care? During the first 2 years following the loss, I did very simple things to work through my grief. I took long walks, spent time with my family (including my dog), and began seeking out the stories of others who had made the difficult choice to terminate a pregnancy for a medical reason. Back then there were a few online forums but they were not as extensive or as well-populated as they are now. I went to therapy. I cried. And I got pregnant again. I kept busy and moved forward while continuing to think about and grieve for the baby I lost.
In general, self-care for the clinician or the client can only begin when the individual feels deserving of self-care. Feeling compassionate toward oneself is a necessary first-step in building self-care. When women lose a pregnancy there is often guilt and self-reproach. I find that feelings of guilt are particularly pronounced in women who have terminated a pregnancy for a medical reason. Working through this guilt can be very helpful in improving self-care. Clinicians should pay close attention to guilt feelings in clients and how these may get in the way of good self-care.