Town hall 3: Finding our footing

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Hello everyone. Hi there. Thanks for making
it into this room. I know we had a little

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bit of technical difficulties, but everyone
who made it, I’m so glad you’re here. My name

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is Amy Van Es and I’ll be your host and moderator
for this session.

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I’d like to begin by acknowledging the land
on which McMaster University is located, which

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is the traditional territory of the Haudenosaunee
and Anishinaabe Nations, and within the lands

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protected by the “Dish with One Spoon”
wampum belt. That wampum uses the symbolism

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of a dish to represent the territory and one
spoon to represent that the people are to

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share the resources of the land and only take
what they need.

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We seek a new relationship with the original
peoples of this land, one based in honour

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and deep respect. May we be guided by love
and right action as we transform our personal

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and institutional relationships with our Indigenous
friends and neighbours.

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It is in the same spirit that I welcome all
of you to our third of three town halls. Today’s

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event is focused on self-care and self-compassion
for healthcare providers to cope with the

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occupational stress during the pandemic.

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This event is supported by the Public Health
Agency of Canada as part of their work to

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address P T S D and trauma in those most affected
by COVID-19.

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In this town hall, we may discuss healthcare
providers who have experienced challenges

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in their work and home life during the pandemic.
There could be moments that are disturbing

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to you, and it’s totally fine if you wish
to excuse yourself from this event at any

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point.

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Additionally, if you require wellness support,
there are a number of wonderful organizations

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ready to help. You can learn more about each
from the links in the chat.

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Over the past two and a half years, we’ve
heard so much about the strain on the healthcare

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system and on healthcare providers due to
the pandemic, and we owe a debt of gratitude

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to all the physicians, nurses, therapists,
personal support workers, and public safety

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personnel who, despite facing incredible challenges
in their daily work lives, still found the

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time and courage to talk to us and share their
experience.

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This research project aims to shine a light
on the impact that the pandemic has had on

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the mental health of all those healthcare
providers who have given so much of themselves

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to the service of others and continue to do
so. The evidence-based resources and tools

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we’re offering to help build mental health
literacy, support and resiliency are our health,

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healthcare salute: our way of saying thank
you so much for your service.

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One more thing. Before we get into the meat
and potatoes of today’s topic, I wanted to

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let you know that there will be time for our
experts to answer your questions towards the

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end of the hour. So to submit questions you
can use the q and a function that’s at the

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bottom of your screen, and they’ll show up
on my end of things when it comes time for

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the panel discussion.

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We’ve also just posted a code of conduct in
the chat, so please, let’s all work together

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to ensure this remains a safe space for sharing
and learning for everyone.

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So to begin our program today, we’re going
to watch a pre-recorded presentation by Mauda

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Karram, who will join us live today as well.
In the talk, she’ll be diving into some findings

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from her recent research about self-care and
self-compassion for healthcare providers during

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the pandemic.

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Mauda is a clinical research assistant in
the Trauma and Recovery Research Unit at McMaster

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University. She completed her undergraduate
degree at McMaster in the psychology, neuroscience

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and behavior program with a mental health
specialization and a minor in theatre and

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film studies. Currently, she’s the project
coordinator of this ongoing Canada-wide project

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on moral injury.

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Thank you so much Mauda, for sharing — or
for contributing to the conversation today.

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And let’s take a peek at the recording.

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​

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Hello everyone. We’d like to thank you all
for being here today. My name is Mauda Karram,

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and on behalf of the Trauma and Recovery Research
Unit at McMaster University, I’d like to share

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some of our research findings with you on
healthcare providers, self-care and self-compassion

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during the COVID-19 pandemic.

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During the COVID-19 pandemic healthcare providers
have endured prolonged periods of heightened

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stress as well as exposure to potentially
traumatic events. In times of distress, uncertainty,

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[and] increased workloads, we want to know
how healthcare providers have cared for themselves

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and their mental health during the COVID-19
pandemic.

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We conducted a research study out of the Trauma
and Recovery Research Unit at McMaster University,

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where we invited healthcare providers from
across Canada to share with us their experiences

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during the COVID-19 pandemic. This study had
both an interview portion and a survey portion

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where we collected myriad data, some of which
we’d like to share with you today.

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Today we’re going to take a deeper look into
how healthcare providers have coped with stress

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during the pandemic, and whether healthcare
providers have demonstrated self-compassion

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towards themselves.

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With the interview portion of our study, we
were able to hear firsthand the experiences

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of healthcare providers during the COVID-19
pandemic. Healthcare providers were asked

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a series of questions related to various mental
health challenges and impacts they’ve encountered.

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Today, we hope to magnify the perspectives
of healthcare providers when asked the following

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question: “Some people use various types
of coping strategies when they’re experiencing

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stressful situations. Have you used any particular
strategies to help you cope?”

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Here we have the data from 48 out of the 51
participants who provided demographic information.

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As illustrated by the data here, participants
were mainly female respiratory therapists

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residing in Ontario. Results from our study
revealed two overarching themes each with

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two subthemes.

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I’ll begin with our first theme here, shifting
approaches to coping.

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So overall, from what we’ve heard from healthcare
providers, there seems to have been a constant

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shift in how healthcare providers approach
their choices of coping strategies. As we

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will talk about in the second theme, these
approaches were often influenced by changing

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barriers and differing waves of the pandemic.

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Ultimately, healthcare providers navigated
their way through coping with the challenges

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they faced on a day-to-day basis, in an attempt
to find out what works best for them and their

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own mental health.

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in this quote, this healthcare provider had
initially turned to the use of alcohol as

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a coping strategy, but decided to seek professional
advice and ultimately turn to meditation and

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a useful sleep routine.

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On the one hand, healthcare providers describe
this feeling of being able to make an intentional

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effort to cope and improve their mental health
in a way that they perceive to be healthy,

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positive, and effective in reducing stress,
both short term and long term.

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This healthcare provider spoke about strategies
such as yoga, therapy and meditation, where

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they describe them as methods for self care,
ultimately creating a positive impact on the

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individual’s life where they describe these
behaviours they will carry on past the pandemic.

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Towards the other side of these approaches
to decision making, some healthcare providers

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sought out coping strategies that were lower
effort and easily accessible, often due to

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the lack of bandwidth or capacity to make
an intentional effort. Importantly, healthcare

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providers describe these strategies as negative
or unhealthy, yet continued to use them as

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they still provided that desired result of
distraction, relaxation, numbing out physical

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and emotional stress, and avoiding having
to process their emotions.

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Examples from this quote here included alcohol
use and binge eating viewed as a temporary

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solution, ultimately creating these feelings
of guilt.

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Onto the second overarching theme from the
experiences shared by healthcare providers,

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many described a range of barriers that impeded
upon their usual ways of coping to manage

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work-related stress.

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First, we have pandemic-related restrictions
where healthcare providers reported an inability

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to access their usual or desired coping strategies
due to government-level policies that were

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put in place that apply to everybody. This
included various closures and limits on social

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gatherings, as illustrated by these quotes.

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Healthcare providers would describe these
strategies as being not allowed or that they

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can’t do what they normally would do to support
their mental health.

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And then we have these circumstantial barriers
where various circumstances of the individual

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influence their ability to engage coping strategies
to reduce stress. These circumstances were

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specific to the healthcare provider and their
own individual experiences, and included various

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barriers such as seasonal changes, exhaustion,
lack of motivation, and a key aspect of perceived

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impacts on family and friend relationships.

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Here, there were a few factors at play where
healthcare providers described that they would

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refrain from seeking social support from family
and friends as they were fearful of traumatizing

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them with their experiences, feeling like
a burden to their loved ones, that their loved

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ones wouldn’t truly understand, and that oftentimes
they wouldn’t want to engage in conversations

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about political views on vaccines and masks.

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So now we’d like to turn our attention to
the topic of self-compassion, what it means

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to be self-compassionate, and how we can measure
self-compassion in individuals.

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Self-compassion is demonstrated through behaviours
and thoughts one has towards themselves.

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It is when one is open and moved by their
own suffering, caring, kind, understanding,

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and non-judgemental to themselves and their
inadequacies, and recognize their own experiences

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as part of the common human experience.

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So by looking at self-compassionate behaviors,
we can understand one’s responses to pain

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and failure, one’s predicament, and how one
pays attention to their own suffering.

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Here we have some quotes from healthcare providers
in our study where they’ve touched on various

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aspects of self-compassion in ways in which
we will discuss shortly. As highlighted In

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blue, we see phrases such as “We’re all
going through the same thing”; “It’s

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hard to ask for help when you feel that maybe
someone else or there are other people that

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are more deserving of the help”; “I
try to have compassion about the situation”;

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and words such as “permission” and
“guilt.”

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There are essentially two ends to each measure
of self-compassion, according to Kristin Neff,

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whom is an expert in the field of compassion
and self-compassion.

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Here we have a positive poll where behaviors
are compassionate and a negative poll where

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behaviors are unpassionate.

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In this first column, we have self-kindness
and self-judgment. Self kindness refers to

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the gentle and understanding attitude towards
oneself and expressing unconditional acceptance

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towards oneself. Self-judgment on the other
hand, refers to the harsh judgment of oneself

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for shortcomings. In the second column, common
humanity speaks to the notion that all humans

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fail or make mistakes, and no one person can
lead a perfect life.

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On the other hand, isolation is when one feels
isolated by their imperfections, as if they

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are the only one who failed or is suffering.

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In the final column, mindfulness is being
aware of one’s suffering experience in the

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moment and seeing it with clarity, on the
other hand, over-identified as having an exaggerated

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storyline of the negative aspects of self.

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Today we’d like to share the results from
this self-compassion questionnaire from healthcare

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providers across Canada who participated in
the survey.

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So 426 participants completed the self-compassion
scale In the survey portion of our study.

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Of note, participants were mainly female nurses
residing in Ontario.

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So healthcare providers scored similarly on
scales aimed to measure self-compassion as

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scales aimed to measure negative self-compassion,
and this was similar across all professions.

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The overall results indicate moderate levels
of self-compassion.

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Further, looking at how self-compassion scores
compared with other measures in our study,

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preliminary findings reveal a potential relationship
between self-compassion and resiliency and

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self-compassion and emotion regulation. Specifically,
data show a significant positive correlation

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between self-compassion and resiliency. So
here where participants scored higher on self-compassion,

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they also scored higher on resiliency.

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Also, data showed a significant negative correlation
between self-compassion and difficulties in

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emotion regulation, where participants who
scored higher on self-compassion scale also

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scored lower on the difficulties in emotion
regulation scale.

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So overall and in summary today, healthcare
providers have struggled to engage in usual

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coping strategies due to various COVID-19–related
barriers, and we saw here that healthcare

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providers fluctuated between an intentional
effort and a quick-fix decision influenced

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by various factors including closures, circumstantial
barriers, and differing weights of the pandemic.

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So we see here that there is an urgent need
to develop supports and resources for healthcare

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providers to cope with occupational stress
and the unique psychological burden of the

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COVID-19 pandemic to improve mental health
outcomes. And we also saw what these moderate

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self-compassion scores, that they point to
the necessity to understand how we can support

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healthcare providers by not only providing
coping tools, but addressing various factors

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impacting mental health and the ability to
seek coping strategies.

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Thank you all so much for being here today
and allowing me to share with you some of

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our important findings from our research.
These were our references for today,

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and we’d like to also thank our collaborators
and supporters.

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​

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Thank you so much for sharing your research.
Mauda. You know, it’s clear that there’s a

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real need for resources to be developed to
help health healthcare providers who have

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just like given, given, and given once more
to cope with their work during the pandemic.

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So let’s develop some ideas right here. I’d
like to invite a few more people to the table

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to continue this discussion and get into the
nitty gritty of how to integrate self-compassion

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into our lives.

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So welcome to this digital room, Kim Ritchie,
Hugo Schielke, Margaret McKinnon, and Mauda

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Karram. I see you all coming in.

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Ah, hello. Hi folks. Okay, so we’ve already
met Mauda, but for the rest of you, I was

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hoping you could each take a moment to introduce
yourselves and tell us a bit about your role

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as it relates to our topic today. Margaret,
do you mind if we start with you?

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Thank you so much Amy. So my name is Margaret
McKinnon.

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I’m the Homewood chair in mental health and
trauma, and I’m also a professor in the Department

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of Psychiatry and Behavioural Neurosciences
at McMaster. My trade, as we say in the military

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work we do, is I’m a clinical psychologist
and clinical neuropsychologist. And I have

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had the privilege of serving on the front
lines of the pandemic, so spending times,

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time rather, in the hospitals providing supports
to staff on COVID units and ICU units.

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Thank you, Margaret. And what about you, Hugo?

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Hello everyone. My name is Hugo Schielke.
I’m the trauma services development lead for

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Homewood Health. Also a clinical psychologist
specialized in helping people with trauma

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dissociative disorders. And I guess my relationship
to this topic is that without self-compassion,

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you really aren’t able to allow yourself to
give yourself the care you need.

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And so that, that’s what we’ll be talking
about today.

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Thank you, Hugo. And Kim, would you like to
introduce yourself?

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Hi everyone. My name’s Kim Ritchie and I’m
an assistant professor at Trent University,

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and I also hold an adjunct position in at
McMaster University in the Department of Psychiatry

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and Behavioural Neurosciences.

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With this lab, I’m also — my background
is I’m a registered nurse, and primarily in

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mental health.

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Thank you Kim, and welcome everyone again.
Do Hugo, I’d love to start with you, and I’d

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really love to start by grounding us, all
in this room, in a shared understanding of

0:16:38.050,0:16:39.769
the topic we’re going to talk about today.

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So my big question, and I think probably a
question for the audience is, is there a difference

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between self-compassion and self-care?

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That is such a good question. And the short
answer is yes. The longer answer is that,

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again, I guess in some ways I already spoke
to this, that it is very, very, very difficult

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to give yourself the care you need if you
aren’t being fair and gentle and kind and

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compassionate with yourself.

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And so each of those words is different ways
of saying compassionate, right? So being fair

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is another way of being compassionate, right?
So making sure you’re not judging yourself

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overly harshly, which is what we tend to do
in this culture and these cultures. We’ve

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learned that to make changes, we need to judge
ourselves harshly when in fact the opposite

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is true when you look at the research.

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And so lots more I can say about this, but
the short answer to your question is, yes,

0:17:35.350,0:17:42.120
so self-care is giving yourself the care you
need, and what allows us to do that is to

0:17:42.120,0:17:46.010
relate to ourselves in a compassionate way,
right? To be gentle with ourselves, to be

0:17:46.010,0:17:49.140
interested in what’s going on, to validate
what’s valid, and have an easy manner with

0:17:49.140,0:17:52.830
ourselves and encouraging ourselves to give
ourselves that care when we need it.

0:17:52.830,0:17:59.080
Okay. Wonderful. So self-compassion, the compassion
is like the feeling and the desire to treat

0:17:59.080,0:18:02.049
yourself, and the self-care are the actions
that you take. Would that be right?

0:18:02.049,0:18:03.049
Yeah.

0:18:03.049,0:18:04.049
Okay, great, thank you.

0:18:04.049,0:18:07.270
We think of it as like the how and the what,
right? So self-compassion is how you relate

0:18:07.270,0:18:10.770
yourself, and then self-care is what you do
to take care of yourself.

0:18:10.770,0:18:13.659
Excellent, excellent. Okay. Thank you.

0:18:13.659,0:18:17.620
Mauda, I’d love to know — thank you so much
again for sharing your research — I’d love

0:18:17.620,0:18:22.100
to know what the most sort of surprising or
insightful outcome of that research was for

0:18:22.100,0:18:23.100
you.

0:18:23.100,0:18:28.860
Yeah. Thank you, Amy. I think, you know, ultimately
having the privilege of listening to healthcare

0:18:28.860,0:18:32.970
providers experiences and being that point
of contact between what’s happening on the

0:18:32.970,0:18:37.450
front lines and how we can play a role in
helping, I think that’s all kind of been truly

0:18:37.450,0:18:38.450
insightful.

0:18:38.450,0:18:43.539
Most specifically, I guess what resonated
with me was that for healthcare providers

0:18:43.539,0:18:47.990
who turned to those quick fix strategies that
I talked about in the presentation that were

0:18:47.990,0:18:53.450
perceived to be unhealthy or that those who
struggled to cope to reduce their stress,

0:18:53.450,0:18:58.020
it wasn’t necessarily that perhaps healthcare
providers didn’t want to cope or didn’t want

0:18:58.020,0:19:01.429
to put in that additional effort to support
their mental health.

0:19:01.429,0:19:05.690
Because many healthcare providers expressed
the desire to cope and even mentioned that

0:19:05.690,0:19:10.770
if they had perhaps had more benefits or more
bandwidth, that some desired strategies would’ve

0:19:10.770,0:19:15.480
been more accessible. And although it may
not seem like this at first glance, speaking

0:19:15.480,0:19:20.470
on behalf of the research point of view, it
allows us to see and hear from healthcare

0:19:20.470,0:19:24.990
providers what they need to cope, so that
we can find ways to help reduce that burden

0:19:24.990,0:19:31.900
of having to use rest time and extra energy
to scramble seeking what’s available. And

0:19:31.900,0:19:37.179
you know, you’ll hear some of these strategies
today from us, to combat these barriers and

0:19:37.179,0:19:41.720
ease the process of self-care and coping so
that it isn’t this unachievable for healthcare

0:19:41.720,0:19:45.100
providers to be able to care for themselves
and their mental health.

0:19:45.100,0:19:50.110
Yeah, wonderful. Thank you, thank you for
saying that. That kind of segues perfectly

0:19:50.110,0:19:56.470
into my next question, which is, in that presentation
we learned about these quick fixes, right?

0:19:56.470,0:20:00.290
The examples that were shared were alcohol,
binge eating — because they provide that

0:20:00.290,0:20:05.110
desired stress relief in the small amount
of time that we know healthcare providers

0:20:05.110,0:20:07.549
have to focus on themselves.

0:20:07.549,0:20:16.740
So Hugo, I’m wondering, these quick fixes
strategies also mentioned sort of end up in

0:20:16.740,0:20:21.680
a residual feeling of guilt. So my question
is, how can healthcare providers begin to

0:20:21.680,0:20:24.700
work past that guilt?

0:20:24.700,0:20:29.150
Such a good and really important question,
right? So if we look at, maybe part of it

0:20:29.150,0:20:35.270
is, the way I think about this is that self-understanding
enables self-compassion, which then enables

0:20:35.270,0:20:36.270
compassionate action, right?

0:20:36.270,0:20:40.640
So it’s actually three steps. Sometimes people
think, I just need to do this thing. But to

0:20:40.640,0:20:47.100
get there is actually lots of steps and easiest
broken down into three. And so how do they

0:20:47.100,0:20:51.679
get past that guilt, towards that compassion
action? So the first part is a fair self-understanding.

0:20:51.679,0:20:55.490
That it makes so much sense that when you’re
overwhelmed, you reach to the things that

0:20:55.490,0:20:59.039
you know of helped even a little bit, even
just for a short period of time, because at

0:20:59.039,0:21:00.400
least it’s some form of relief.

0:21:00.400,0:21:05.400
So it’s about having, again, a fair relationship
with yourself, not shaming yourself for doing

0:21:05.400,0:21:12.940
the best you know how so far, right? And then
the next piece is knowing that it is also

0:21:12.940,0:21:17.450
really hard to change how you give yourself
the care you need and from a quick fix to

0:21:17.450,0:21:23.570
something that is something that helps for
a longer period of time, but might take longer

0:21:23.570,0:21:26.179
to help you to get into that routine of doing
that.

0:21:26.179,0:21:31.840
And also for, to feel those effects, right?
So it’s knowing that you have to give up something

0:21:31.840,0:21:38.420
to work towards something. And that also means
number one, knowing what those other things

0:21:38.420,0:21:43.660
are. Two, trusting that they’ll work enough
to want to practice them. Then three, practicing

0:21:43.660,0:21:47.320
them, usually when you don’t need them, so
that you’re more able to do it when you really

0:21:47.320,0:21:49.750
need to rely on that skill.

0:21:49.750,0:21:55.730
And then it’s really during those times when
you’re really struggling, again, being gentle

0:21:55.730,0:21:59.210
with yourself. It’s sometimes I think about
this as like giving yourself the care you

0:21:59.210,0:22:04.220
need, and there’s an acronym. One part I borrow
from D.B.T., one part developed to help trauma

0:22:04.220,0:22:09.290
patients. So the first letter is “G”:
so to give yourself the care you need. So

0:22:09.290,0:22:13.010
“G,” being gentle with yourself,
is all the how. Gentle with yourself.

0:22:13.010,0:22:19.500
“I” is interested in why you might
be feeling this way and what you might be

0:22:19.500,0:22:23.970
missing, right? Or what might change how you
feel if you noticed it. Right?

0:22:23.970,0:22:28.309
“V” is validating what’s valid.
So being fair with yourself, but not what’s

0:22:28.309,0:22:31.650
not — so you don’t tell yourself I’m a horrible
human being for suffering this way. I’m just

0:22:31.650,0:22:34.100
human for suffering like this, right?

0:22:34.100,0:22:38.850
“E” stands for easy manner. So being
kind and gentle and fair with yourself, even

0:22:38.850,0:22:40.770
if you’re not able to do things the way you
wish to yet.

0:22:40.770,0:22:44.720
And then the care. So for giving yourself
the care you need. The “C” stands

0:22:44.720,0:22:48.970
for being curious about what could really
help in the situation, all the different things

0:22:48.970,0:22:53.110
I know I’m learning, I’ve been working towards,
what could really help in this moment?

0:22:53.110,0:22:57.650
“A” stands for, the “A”
of care, stands for acknowledging that change

0:22:57.650,0:23:00.100
is hard. Doing things differently is difficult.

0:23:00.100,0:23:04.830
“R” stands for reflecting on, of
the different options, which one is most likely

0:23:04.830,0:23:07.760
to help me get to where I want to be?

0:23:07.760,0:23:11.990
And “E” stands for encouraging yourself
to do that thing that you’ve decided is probably

0:23:11.990,0:23:15.740
the best thing, even and especially — so
it’s a triple E— so encouraging yourself

0:23:15.740,0:23:20.340
even, especially when it’s hard, because the
reality is we all know that changing habits

0:23:20.340,0:23:22.029
are hard.

0:23:22.029,0:23:23.029
Yeah.

0:23:23.029,0:23:27.920
And the last bit I’ll say here to make sure
people are fair with themselves is that again,

0:23:27.920,0:23:28.920
it’s steps.

0:23:28.920,0:23:32.340
So it’s learning what you can do ahead of
time. Understanding that what you’re doing,

0:23:32.340,0:23:35.020
you don’t want to anymore. Getting to a place
where you’re going to learn something new,

0:23:35.020,0:23:40.140
practicing it. And then what tends to happen
is you notice first after you could have,

0:23:40.140,0:23:45.460
and here’s where people may shame themselves
for, I knew better then I did it, right? But

0:23:45.460,0:23:50.900
actually this is an occasion to give yourself
credit because, oh wait, I now know that I

0:23:50.900,0:23:54.190
can do something different. That’s actually
an accomplishment, not a reason for shame.

0:23:54.190,0:23:55.190
Does that makes sense?

0:23:55.190,0:23:56.190
Yeah.

0:23:56.190,0:23:58.380
And the same thing is true. So it’s first
after that you notice, then it’s during, but

0:23:58.380,0:24:01.830
you can’t do the new thing yet, then it’s
before, but you can’t do the new thing yet

0:24:01.830,0:24:04.410
and then it’s before you’re like, oh my God,
I think this time I would actually be able

0:24:04.410,0:24:08.570
to do it, right? And so it’s again, being
really fair with yourself. So how do you get

0:24:08.570,0:24:14.450
out of the guilt? It starts by having a fair
understanding of yourself, and a relationship

0:24:14.450,0:24:20.110
with yourself that is gentle, interested,
validating, easy mannered, curious, acknowledging,

0:24:20.110,0:24:25.210
reflecting, and really encouraging yourself
to even when it’s hard to not give up and

0:24:25.210,0:24:26.809
to take that step.

0:24:26.809,0:24:35.350
Beautiful. Thank you. You know Margaret, Hugo
mentioned, you know that, I guess what I’ll

0:24:35.350,0:24:40.809
say is that it makes sense to me that one
way to adjust this behaviour, like the the

0:24:40.809,0:24:45.120
quick fixes that we started this discussion
with about is to make self-compassion more

0:24:45.120,0:24:46.120
accessible.

0:24:46.120,0:24:49.020
And I think that’s kind of Hugo, what you
were saying, right? We need to be fair with

0:24:49.020,0:24:54.000
ourselves and we need to just like take the
little steps of practice when we’re not in

0:24:54.000,0:24:56.919
this moment of crisis of really, really truly
needing it.

0:24:56.919,0:25:02.669
So I’m wondering, Margaret, what are some
equally low-effort strategies that healthcare

0:25:02.669,0:25:05.130
providers could integrate into their day,
to practice?

0:25:05.130,0:25:13.020
Thanks, Amy. And I want to start, having been
on the COVID and ICU units and medical floors

0:25:13.020,0:25:18.440
and other places in the hospitals during the
pandemic, and what we often heard from people

0:25:18.440,0:25:25.730
was, “I can’t take a break. I don’t want
to let my team down. If I take a break then

0:25:25.730,0:25:28.490
others have to fill in for me.”

0:25:28.490,0:25:34.770
And that’s a really hard place to be in when
we feel that if we take that time and have

0:25:34.770,0:25:40.320
that self-compassion for ourselves, that we’re
letting others down. And I think one really

0:25:40.320,0:25:45.340
simple thing that we can say to ourselves
is that if we don’t put the oxygen masks on

0:25:45.340,0:25:48.929
ourselves, we won’t be able to help others.

0:25:48.929,0:25:53.059
And it often sounds like something that we’ve
been told for years and years and years, but

0:25:53.059,0:25:59.080
it’s really true. It’s hard to accept sometimes,
but it’s true. And I think part of this is

0:25:59.080,0:26:03.890
giving ourselves the permission to be able
to take, to use these strategies.

0:26:03.890,0:26:10.410
I’m going to say also that often healthcare
workers have a sense of duty. And duty I think

0:26:10.410,0:26:14.580
is something I know myself I struggle with,
that I have such a sense of duty that I’ll

0:26:14.580,0:26:20.059
work to the point of exhaustion. Or stay somewhere.
I stayed in — I was at a hospital once for

0:26:20.059,0:26:24.890
36 hours and I was in the storage closet most
of that time, right? Not sleeping because

0:26:24.890,0:26:29.450
I just felt so strongly that I had a duty
to support others.

0:26:29.450,0:26:34.340
And I think that’s often where we find ourselves
in as healthcare workers, is our sense of

0:26:34.340,0:26:40.340
duty and our obligation, which is so important
and such a valuable part of our identity,

0:26:40.340,0:26:44.510
but also something that I think until we can
put that oxygen mask on ourselves is very

0:26:44.510,0:26:46.950
difficult. And so —

0:26:46.950,0:26:51.880
Sorry Margaret, I didn’t mean to cut you off.
I was just wondering actually if you could

0:26:51.880,0:26:56.380
share more about that experience because I
think that that experience in the closet at

0:26:56.380,0:27:03.210
the hospital is really pertinent to this conversation,
right? Like what you were doing was providing

0:27:03.210,0:27:07.730
a moment of respite for the healthcare providers.
So I’m wondering if you could explain more

0:27:07.730,0:27:12.140
about what that was and how you feel that
affected the healthcare providers.

0:27:12.140,0:27:18.321
Yeah, absolutely. And so I was in the storage
closet on an ICU unit and healthcare workers

0:27:18.321,0:27:23.090
don’t have a lot of time, right? That’s the
other part of this is, Hugo and Mauda were

0:27:23.090,0:27:25.700
talking about, there’s not a lot of time,
and so how do we help people to take that

0:27:25.700,0:27:31.350
pause for a moment and just either talk to
someone about the experiences that they’re

0:27:31.350,0:27:37.210
having or do something that help can help
to get them in the moment and present.

0:27:37.210,0:27:41.130
And so we can think about very simple things.
For example, using our senses, so our sense

0:27:41.130,0:27:49.720
of touch or sight or sound or smell. So one
very simple thing that, that I do is I have

0:27:49.720,0:27:54.000
worry stones. So these are worry stones. They’re
just simple stones that you could hold in

0:27:54.000,0:27:56.230
your hand and rub your fingers on.

0:27:56.230,0:28:00.809
And what that you’re doing there is that you’re
paying attention to the sensation of the stones

0:28:00.809,0:28:05.299
in your hands, you’re rubbing your fingers
on them, and it’s just a way of simply grounding

0:28:05.299,0:28:12.490
yourself in the moment. That’s one very low,
I would say low effort, yet high reward strategy

0:28:12.490,0:28:14.390
that healthcare workers might be able to use.

0:28:14.390,0:28:19.370
We call this grounding. So that notion of
using your senses to help keep you in the

0:28:19.370,0:28:25.390
moment. It’s also that permission when you
come home to say to your family, for example,

0:28:25.390,0:28:30.250
“I’ve had a really difficult day, I really
need a break.” Because often we come

0:28:30.250,0:28:34.990
in and say, “I want to make sure so-and-so
is okay. I want to call so-and-so. I want

0:28:34.990,0:28:39.600
to make sure everything is right for everyone
else.” And that’s especially hard when

0:28:39.600,0:28:42.940
you’re a parent, right? When you come home
and everybody comes to the door and they’re

0:28:42.940,0:28:48.409
waiting for you. But can we give ourselves
permission again to take that time? Just to

0:28:48.409,0:28:55.029
say no distractions, no conversation, I need
this moment for myself.

0:28:55.029,0:28:58.120
It’s also really important to think about
the things that have helped us in the past.

0:28:58.120,0:29:03.549
I often say mental health is not rocket science.
It’s actually think in the past about what’s

0:29:03.549,0:29:07.659
helped you. So for example, I know for me,
I know when I’m overwhelmed, when I get irritable,

0:29:07.659,0:29:12.880
that’s a very bad sign for me if I’m irritable.
Cause I’m not generally an irritable person.

0:29:12.880,0:29:16.840
And so when that happens, I want to think
about what’s helped in the past. Generally

0:29:16.840,0:29:23.450
that’s doing something social, having a bath,
sitting down with my dog and petting her,

0:29:23.450,0:29:30.390
whatever that may be. These low effort strategies—
low efforts are often hard, because while

0:29:30.390,0:29:36.520
they sound low effort, it’s taking that time
to give yourself permission to take that break.

0:29:36.520,0:29:40.737
It’s also allowing yourself to say, I’m not
going to take an extra shift. I am going to

0:29:40.737,0:29:41.980
take a day off.

0:29:41.980,0:29:42.980
Mm-hmm.

0:29:42.980,0:29:48.570
And again, when we have that sense of duty
and obligation, which we all, I think, come

0:29:48.570,0:29:53.370
to these helping professions with, but be
that public safety personnel like paramedics

0:29:53.370,0:29:58.270
or firefighters, and we come with that sense
of duty. Where come because we want to help

0:29:58.270,0:30:04.780
others. But again, we can’t help others unless
we’re able to help ourselves and put that

0:30:04.780,0:30:06.420
oxygen mask on ourselves.

0:30:06.420,0:30:13.890
Yeah, absolutely. And one of the things that
was mentioned in the talk was, so many people

0:30:13.890,0:30:19.000
have a hard time talking to loved ones about
this experience — and actually when I first

0:30:19.000,0:30:25.120
came into this topic and I was doing research
on for this very talk, I thought, oh, well

0:30:25.120,0:30:28.380
that’s a really good, that’s a really good
support, is talking to your loved ones.

0:30:28.380,0:30:35.820
Like, how can you like engage them without
burdening them? But I actually think maybe,

0:30:35.820,0:30:42.770
because that’s so complicated from both sides
of the coin, right? So my question for you

0:30:42.770,0:30:47.370
Kim, is given that so many people have a hard
time talking to their loved ones about these

0:30:47.370,0:30:53.090
experiences that they’ve been through, what
else could you recommend for person-to-person

0:30:53.090,0:30:54.090
support?

0:30:54.090,0:31:00.620
Yeah. Thanks so much, Amy. That’s a great
question. And I think one of the things we’ve

0:31:00.620,0:31:05.970
really learned from the research and we talk
a lot about in the interviews actually, is

0:31:05.970,0:31:11.500
that healthcare providers are really, really
good at taking care of others. And as we said

0:31:11.500,0:31:17.580
here too, and really delivering that patient-centered
care, but really struggle with turning that

0:31:17.580,0:31:20.639
to themselves and taking care of themselves.

0:31:20.639,0:31:26.420
And, you know, Margaret also mentioned about
identity, and I think healthcare providers

0:31:26.420,0:31:32.560
see themselves as — they’re the ones who
take care of others, and that’s part of the

0:31:32.560,0:31:39.220
culture. And it kind of goes against the culture
to turn that inwards and to start looking

0:31:39.220,0:31:40.230
at themselves.

0:31:40.230,0:31:50.029
So I think at work, taking care of each other
is important too, and supporting each other.

0:31:50.029,0:31:58.840
And I think teams already do that. But it
might just be recognizing your colleagues,

0:31:58.840,0:32:05.390
and giving them permission to take time for
themselves, in addition to giving yourself

0:32:05.390,0:32:07.110
permission.

0:32:07.110,0:32:16.120
And I think at home, as Margaret said, I think
being aware of your need to take time for

0:32:16.120,0:32:22.820
yourself, I think that’s the first step. But
then actually being able to find a way to

0:32:22.820,0:32:30.790
take that few minutes that you might need
just to care for yourself is also a strategy

0:32:30.790,0:32:32.320
that you could use at home.

0:32:32.320,0:32:37.580
I almost wonder, Hugo as well. I mean, you’re
very expert in this, and I wonder if you’d

0:32:37.580,0:32:41.000
like to talk a little bit more about grounding
and some of the ways that people can use sites

0:32:41.000,0:32:45.600
or their — use their senses to assess with
some of this as well.

0:32:45.600,0:32:52.620
Sure, happy to. So first of all, I’d say you
did a lovely job of describing, like finding

0:32:52.620,0:32:55.470
those things that speak to you and connecting
with them, right?

0:32:55.470,0:33:00.019
Because that’s really at the heart of grounding
. Well, there’s kind of two components really,

0:33:00.019,0:33:04.200
I guess. The one we’re talking about there
is really anchoring to the present, really

0:33:04.200,0:33:08.310
helping yourself — you can think of like
a ship, right? We feed an anchor into the

0:33:08.310,0:33:14.860
present. But it also is a pulling yourself
into, like, if you think about grounding as

0:33:14.860,0:33:18.059
like an image, you can be too far away from
the ground, like overwhelmed.

0:33:18.059,0:33:22.080
Where you can be so overwhelmed, you kind
of collapse and feel like you’re underground,

0:33:22.080,0:33:26.830
right? And so grounding is a set of skills
that helps you get to level ground, if that

0:33:26.830,0:33:31.381
makes sense. And so sometimes that’s when
something reminds us of the past and we start

0:33:31.381,0:33:35.980
to feel like this is like, or just like the
past, or because the present is so currently

0:33:35.980,0:33:40.250
overwhelming that we’re feeling overwhelmed
or just so overwhelmed and flooded that we

0:33:40.250,0:33:46.859
shut down and collapse. And grounding is great
for any and all of those things. And yeah,

0:33:46.859,0:33:51.880
lots of different ways to do it. At the heart
of it is really, helping yourself focus your

0:33:51.880,0:33:58.760
attention on the here and now. And there’s,
and I would say that different strategies,

0:33:58.760,0:34:02.490
different grinding strategies work differently
well for different people.

0:34:02.490,0:34:07.720
So to not give up if one doesn’t resonate
with you right away, but to know there’s lots

0:34:07.720,0:34:12.639
of them. And so here’s just a couple, right,
a couple ideas. The first is, Margaret as

0:34:12.639,0:34:20.960
you pointed out so beautifully, like if there’s
an object in particular that you find you

0:34:20.960,0:34:23.960
enjoy, the sight, the touch, the feel of,
right?

0:34:23.960,0:34:29.179
Grounding is most effective when we’re working
with what I call like grounding helpers that

0:34:29.179,0:34:33.230
we find we connect with and help us: just
by spending time with it, we feel better.

0:34:33.230,0:34:37.480
Right? So like, for example, you happen to
be wearing a beautiful shawl today, right?

0:34:37.480,0:34:39.810
So, and I imagine, it’s probably soft.

0:34:39.810,0:34:40.810
Yes.

0:34:40.810,0:34:44.910
And so you can use that as a grounding help,
just to kind of notice and describe to yourself

0:34:44.910,0:34:50.540
what does this feel like? Because touch is
often the fastest thing to help us with grounding.

0:34:50.540,0:34:55.329
So worry stones, different textures, different
temperatures, taking a sip of water, right,

0:34:55.329,0:35:01.040
or a warm beverage. Something with the smell
so you can get as many of your sentences as

0:35:01.040,0:35:07.860
possible involved. Making sure your breathing
is a huge part of this. And so for many people,

0:35:07.860,0:35:12.920
part of their grounding helper kit, if they
can think about that way, is sense that they

0:35:12.920,0:35:16.609
enjoy — or like tea, because that way they
can have the smell as they’re having a nice

0:35:16.609,0:35:19.160
warm beverage that’s also soothing.

0:35:19.160,0:35:26.950
It can be having objects that have particular
personal resonance for you or connecting with

0:35:26.950,0:35:32.040
people, and especially pets. Pets can be incredibly
grounding, right? And just as Margaret, you

0:35:32.040,0:35:36.420
were talking about your dog, I couldn’t help
but smile. And that’s the kind of grounding

0:35:36.420,0:35:43.830
that’s especially powerful, is the ones that
help you feel like, oh, yeah, right. Like

0:35:43.830,0:35:47.280
that. What going to, that’s going to be for,
each person’s going to be a little different,

0:35:47.280,0:35:50.800
but those are the ways to reach towards, is
those kinds of pieces.

0:35:50.800,0:35:56.882
Yeah. I find it really insightful the way
that you all are talking. I’ve thought a lot

0:35:56.882,0:36:01.950
about grounding myself, because everyone experiences
some degree of anxiety. So for example, when

0:36:01.950,0:36:05.660
I’m coming to a talk like this, I really like
to engage in grounding practices before I

0:36:05.660,0:36:11.630
enter the room, and then I’m fully present.
But one thing I’ve never heard before is that

0:36:11.630,0:36:15.300
it’s really helpful in grounding to engage
the senses. Like I really think that’s a really

0:36:15.300,0:36:19.290
important kernel of insight for those, because
I think that could —

0:36:19.290,0:36:20.579
All five if you can.

0:36:20.579,0:36:21.579
Yeah, go ahead.

0:36:21.579,0:36:26.950
All five if you can. So the more that you
can be involving and the more you’re connecting

0:36:26.950,0:36:31.220
and — one way to connect with it is to describe
it to yourself as if you were writing. As

0:36:31.220,0:36:35.640
if like someone else, if they were reading
it. Remember those long-form novels, where

0:36:35.640,0:36:39.260
they used to describe way too much detail,
just don’t do that anymore, right? But if

0:36:39.260,0:36:42.630
you were writing that so they could imagine
what you’re going through. Cause that’s how

0:36:42.630,0:36:46.560
you really anchor in, right, is by the dense
description, if that makes sense.

0:36:46.560,0:36:51.340
Right, right. Yeah, I just think that’s so
interesting. Because when I think of the techniques

0:36:51.340,0:36:56.410
that I used to ground myself, they’re all,
most of them are touch, right? Like standing

0:36:56.410,0:36:58.109
barefoot in the grass.

0:36:58.109,0:36:59.109
Mm-hmm.

0:36:59.109,0:37:03.380
Or I have a little — similar to Margaret,
I have a little toy here that I play with

0:37:03.380,0:37:08.690
to keep my hands busy. So I just find that
the senses insight is so interesting.

0:37:08.690,0:37:14.220
Mauda, I’m wondering, what sort of techniques
do you recommend for people, for healthcare

0:37:14.220,0:37:18.780
providers to start, begin to begin engaging
in self-compassion?

0:37:18.780,0:37:24.859
Yeah. Well, I can kind of speak a little bit
to what we’ve heard from healthcare providers

0:37:24.859,0:37:34.120
to daily things that help them cope and reduce
the stress from work. So for example, establishing

0:37:34.120,0:37:40.329
daily routines was a big one, where there’s
adequate time for nutrition, well-balanced

0:37:40.329,0:37:45.560
meals, sleep, exercise, social connections.
And these can be just small little daily things.

0:37:45.560,0:37:50.420
Meal prepping, for example. So that you don’t
have to worry about going home and cooking

0:37:50.420,0:37:55.680
and having that additional stress for the
day. You know, pets: taking the dog on a long

0:37:55.680,0:38:05.400
walk in nature. Practicing breathing. Fresh
air, sunlight, being outdoors. Even some healthcare

0:38:05.400,0:38:11.510
providers describe leaving specific days set
aside for leisure. Things that are enjoyable

0:38:11.510,0:38:16.319
to them, activities that they would have preplanned
so they know that this day’s coming up, there’s

0:38:16.319,0:38:21.430
something to look forward to that I’m going
to enjoy on that day and make me feel good

0:38:21.430,0:38:23.380
about myself.

0:38:23.380,0:38:29.060
And even integrating those daily strategies
such as mindfulness or gratitude practices:

0:38:29.060,0:38:33.650
Wake up first thing in the morning, have these
little practices that you know, Hugo and Margaret

0:38:33.650,0:38:37.640
were talking about, that you can carry that
self-compassion with you on throughout the

0:38:37.640,0:38:41.910
day. Yeah, those are just a few things that
we’ve heard that really work.

0:38:41.910,0:38:45.760
Wonderful. Thank you, Mauda. I’m actually
wondering, I’m going a little off script here,

0:38:45.760,0:38:51.470
but I’ve got a question that I think actually
might be helpful. And I’m wondering if one

0:38:51.470,0:39:00.270
of you could maybe explain what you mean by
practice breathing, and really practically

0:39:00.270,0:39:07.180
explain how someone might engage in that.

0:39:07.180,0:39:09.470
I think Hugo probably be best suited to —

0:39:09.470,0:39:10.470
Okay.

0:39:10.470,0:39:11.470
Sure. Hugo.

0:39:11.470,0:39:15.630
I’ll just do a quick nod to Kara in the chat,
noting shaking as a grounding practice, right?

0:39:15.630,0:39:20.369
Like shaking off, shaking out the stuff. That’s
actually a really great way to, cause movement

0:39:20.369,0:39:25.890
is also a way of like — that in a way, it’s
touch, in terms of like, it’s appropriate

0:39:25.890,0:39:26.940
deception, right?

0:39:26.940,0:39:31.640
That’s a kind of beautiful way to ground and
let it all go. Thank you for sharing that,

0:39:31.640,0:39:37.130
Kara, that’s a beautiful suggestion. Especially
if you’re starting to feel shut down, right?

0:39:37.130,0:39:41.770
Like starting with small movement and working
to bigger movements can be really helpful.

0:39:41.770,0:39:46.980
So yeah, breathing. I mean, I think [there
are] a couple things. One, cause again, that

0:39:46.980,0:39:52.490
self understanding leads to self-compassion
to compassionate action. When we aren’t breathing,

0:39:52.490,0:39:58.430
and I can do this — you can hear me do this
— as I get talking, I get excited and so

0:39:58.430,0:40:01.900
I am really focused on talking and not breathing.

0:40:01.900,0:40:12.660
When we aren’t breathing, a couple things
happen. One, having air helps us feel safe.

0:40:12.660,0:40:18.141
So when we don’t have air, our body actually
has a real reason to not feel safe. And we

0:40:18.141,0:40:22.750
often, when we’re stressed, we kind of hold
our breath waiting for the moment to pass

0:40:22.750,0:40:28.160
or we hyperventilate, right? Like, but neither
one is actually getting our bodies the air

0:40:28.160,0:40:30.000
it needs, right?

0:40:30.000,0:40:34.040
And so our body then is like, oh, you are
worried about this, but now I’m super worried

0:40:34.040,0:40:37.240
about this. And then the mind gets even more
worried, right?

0:40:37.240,0:40:38.400
Right. Like danger.

0:40:38.400,0:40:42.010
Exactly. Cause it’s real danger. If you’re
not getting the air, that is actual danger.

0:40:42.010,0:40:47.470
Right? That’s clear and present danger at
that point. And so having an intentional breathing

0:40:47.470,0:40:52.020
practice, and there’s so many different ways
of doing this, so I would really encourage

0:40:52.020,0:40:56.420
people to just find what resonates for them.
There’s so many different things to try out.

0:40:56.420,0:41:05.170
Most important is to be getting good deep
breaths. Like breathing out longer than in

0:41:05.170,0:41:10.640
helps you relax. Breathing in longer than
out gives you energy. So if you’re feeling

0:41:10.640,0:41:14.920
overwhelmed and anxious, you would be breathing
out longer. If you’re feeling like I need

0:41:14.920,0:41:20.599
to up-regulate myself cause I’m kind of shut
down, you want to breathe in longer.

0:41:20.599,0:41:24.310
But there’s lots. You can do boxed breathing,
you can do all kinds of different counting

0:41:24.310,0:41:30.490
options. The most important thing is just
to make sure you are breathing, and finding

0:41:30.490,0:41:32.050
something that works well for you.

0:41:32.050,0:41:37.190
And of course we always have our breath with
us, right? And that’s the other thing I’d

0:41:37.190,0:41:40.400
say about breathing, and with grounding too,
you always have the ability to shake things

0:41:40.400,0:41:45.840
off or to notice the textures and temperatures
around you, right? Or to notice what the different

0:41:45.840,0:41:49.770
sensations are, even on things that you wear
or carry with you on a regular basis.

0:41:49.770,0:41:53.680
So these are, what’s wonderful about these
two sets of skills is they’re always available,

0:41:53.680,0:41:54.680
right?

0:41:54.680,0:41:55.770
Yeah, absolutely.

0:41:55.770,0:41:59.069
And just to even know that you’re doing them,
which is also a really important thing if

0:41:59.069,0:42:05.339
you’re a healthcare provider or a human being,
who has a hard time giving yourself permission

0:42:05.339,0:42:09.670
to do things in a way that others might see
it, right? You can do grounding and breathing

0:42:09.670,0:42:11.450
and no one can know that you’re doing those
things.

0:42:11.450,0:42:15.880
Yeah, totally. It can be just this, like even
if you’re on a shift, it can be this sort

0:42:15.880,0:42:22.430
of private thing that you just are standing
at the monitor for a moment and taking a second

0:42:22.430,0:42:29.380
for yourself. Yeah, wonderful. Hugo, I’m wondering,
I know you work with folks who deal with occupational

0:42:29.380,0:42:34.861
stress in your work as a clinical psychologist
at the trauma unit at Homewood, so could you

0:42:34.861,0:42:40.250
share a bit about what you’ve observed about
your patients over the course of the pandemic?

0:42:40.250,0:42:47.260
So this is a really good question and also
one that makes me sad at two different levels.

0:42:47.260,0:42:57.930
So the first one is that I think, as a number
of us have talked about, because of the ways

0:42:57.930,0:43:01.630
that people tend to relate to themselves when
they’re drawn to the helping professions,

0:43:01.630,0:43:06.710
which is that they’re very focused on giving
and caring for others rather themselves. So

0:43:06.710,0:43:09.940
the first observation is that a lot of the
people that we would expect to see coming

0:43:09.940,0:43:15.589
in to get help aren’t. And it makes so much
sense, right?

0:43:15.589,0:43:20.940
Because people feel that I need to, this is
what I need to be doing, this work — there’s

0:43:20.940,0:43:27.140
no time to take care of myself. And so to
the first point there, it makes a lot of sense

0:43:27.140,0:43:30.619
to me that people aren’t, who might really
benefit, aren’t able to allow themselves to

0:43:30.619,0:43:35.400
give themselves permission to give themselves
the care they need, right? And so my hope

0:43:35.400,0:43:39.690
is that they do find a way to give themselves
that permission when they really need it in

0:43:39.690,0:43:44.119
terms of reaching out for local support, reaching
out for outpatient support, if that’s available

0:43:44.119,0:43:51.349
to you. I know a lot of people have work-related
support available, and if not, to really encourage

0:43:51.349,0:43:54.359
your system to support that.

0:43:54.359,0:43:59.700
And, or to come in once you feel like you
can do that, right? All of those things. If

0:43:59.700,0:44:04.410
coming inpatient is helpful. If not, outpatient.
All those pieces, right? And also meditation,

0:44:04.410,0:44:07.770
yoga, whatever speaks to you. But making sure
you’re giving yourself the care that you need

0:44:07.770,0:44:09.390
and not ignoring your needs.

0:44:09.390,0:44:14.960
In terms of the people that have come in during
the pandemic, especially healthcare workers,

0:44:14.960,0:44:20.010
all the themes we’ve just talked about just
resonates so deeply. And what I would say

0:44:20.010,0:44:28.109
with great gratitude to everyone on this call,
is for all the work they have done and then

0:44:28.109,0:44:32.369
for the reachers, researchers on this call
for the beautiful work they’ve done in helping

0:44:32.369,0:44:37.520
understand healthcare workers’ experiences,
because that’s helped us as providers be of

0:44:37.520,0:44:42.180
better support, so that we know what people
are going throughout the healthcare pandemic

0:44:42.180,0:44:48.040
, and the healthcare challenges for healthcare
workers, so that we can respond in a way that

0:44:48.040,0:44:52.150
is, again, more understanding, so therefore
more compassionate, which can hopefully facilitate

0:44:52.150,0:44:53.150
more compassionate action.

0:44:53.150,0:44:59.400
But yeah, it has been heartbreaking because
this has been so hard for so many people who

0:44:59.400,0:45:05.059
just often feel no one does understand, because
mostly they can’t, cause they aren’t there,

0:45:05.059,0:45:10.660
right? And one other thing to be aware of
is that, trauma and dissociation are tightly

0:45:10.660,0:45:15.859
linked. So if it’s too much to think about,
we don’t. We disconnect from it. We disassociate

0:45:15.859,0:45:16.859
from it.

0:45:16.859,0:45:22.980
And so people who aren’t exposed to this level
of distress, it’s hard for them to think about

0:45:22.980,0:45:27.980
it, because our brains don’t want to be connected
to distress, right? It’s because it’s overwhelming.

0:45:27.980,0:45:33.470
So our brains start to shut down and that
then makes it harder for people to then speak

0:45:33.470,0:45:36.770
to people. Cause they can tell that others
either don’t understand it or aren’t able

0:45:36.770,0:45:38.771
to stay engaged when they talk about it.

0:45:38.771,0:45:39.771
Right? Yeah.

0:45:39.771,0:45:40.771
And so the more —

0:45:40.771,0:45:41.771
Yeah. Go ahead.

0:45:41.771,0:45:46.680
The more they can allow themselves to get
help from people who are trained to be able

0:45:46.680,0:45:52.330
to remain present during those kinds of pieces,
I think the more helpful that can be.

0:45:52.330,0:45:55.819
Yeah. And that speaks, that’s really pertinent
to the part where I was mentioning about the

0:45:55.819,0:45:58.589
talking to the loved ones, right? Is that
like, it’s not necessarily —

0:45:58.589,0:46:02.520
It’s not that they don’t care. They just can’t
do it.

0:46:02.520,0:46:03.520
Right!

0:46:03.520,0:46:04.520
Yeah.

0:46:04.520,0:46:09.210
They can’t process it. They can’t really understand
it because they haven’t been, like you said,

0:46:09.210,0:46:12.950
exposed to that level of stress.

0:46:12.950,0:46:17.819
And I just wanted to — Margaret, I wanted
to pass to you, because you had mentioned

0:46:17.819,0:46:22.750
earlier a bit about, and I think this relates
to what Hugo was just saying, is that you

0:46:22.750,0:46:29.510
mentioned a bit about the relationship between
sense of duty and self-compassion, and I’m

0:46:29.510,0:46:31.140
wondering if you could just dig into that.

0:46:31.140,0:46:35.960
I don’t have a specific question, but I feel
it’s important because sense of duty I’m sure,

0:46:35.960,0:46:39.850
resonates with many in the audience. So I’m
just wondering if you can speak more about,

0:46:39.850,0:46:44.590
even when you were on the front lines there
how that relationship is and what we can do

0:46:44.590,0:46:47.280
to turn towards self-compassion in that manner.

0:46:47.280,0:46:54.010
Thanks, Amy. And as you say, it’s a difficult
one to pull apart, right? So I think, again,

0:46:54.010,0:46:58.980
we come into these helping professions because
we want to help. And our identity, as Kim

0:46:58.980,0:47:03.859
was saying, really becomes, we’re a helper,
right? That we are here and we’re making these

0:47:03.859,0:47:08.940
sacrifices. And I think many of us believe
in service: that we’re here to serve, and

0:47:08.940,0:47:12.950
therefore that service is the work that we’re
doing.

0:47:12.950,0:47:16.950
And in order to serve, we also have to be
healthy ourselves, right? Or as healthy as

0:47:16.950,0:47:22.290
we can be. Not, and many of us will — I
mean, I’ve struggled with depression and P.T.S.D.

0:47:22.290,0:47:26.730
and I’ve talked very openly about that. I
think it’s really important. But I have to

0:47:26.730,0:47:31.980
see that to help others, I also need to have
self-compassion towards myself, and give myself

0:47:31.980,0:47:37.610
the space and the time to do things that will
help me to be healthy. I will be really upfront

0:47:37.610,0:47:40.680
and say that’s, I find that very difficult.
I will be very upfront with that as a — in

0:47:40.680,0:47:48.059
the many roles that I have, it’s hard, right?
But I think part of it is that we also have

0:47:48.059,0:47:49.940
a duty to ourselves, right?

0:47:49.940,0:47:59.599
So we are the vessels of our own identity,
and we have to care for ourselves too, to

0:47:59.599,0:48:04.685
be able to perform our duty. But also we have
a duty of care to ourselves, we owe it to

0:48:04.685,0:48:07.430
ourselves to take care of us.

0:48:07.430,0:48:12.640
Absolutely. Thank you. Thank you. Margaret,
I just have one, one final question. It is

0:48:12.640,0:48:18.470
also for you. And that is that I can’t help
feel like — we’re talking about self-care

0:48:18.470,0:48:24.369
and that’s so valuable — but I can’t help
but feel like some of the circumstances that

0:48:24.369,0:48:30.630
have led to this very webinar are systemic.
It feels like it needs to be about culture

0:48:30.630,0:48:33.579
change within the healthcare industry as well.

0:48:33.579,0:48:38.350
So Margaret, I’m curious how organizations,
even though they’re also, everyone is stretched

0:48:38.350,0:48:42.470
the limits, including the organizations, but
how can they help healthcare providers right

0:48:42.470,0:48:43.470
now?

0:48:43.470,0:48:49.140
Great question. Thank you, Amy. And I think
part of it is seeing our common humanity.

0:48:49.140,0:48:53.380
So I think healthcare organizations are often
very hierarchically structured.

0:48:53.380,0:48:58.240
So there’s the view that we have, those at
the top and those on the front lines, and

0:48:58.240,0:49:02.560
there’s a lot of hierarchy in that. And I
think part of what we need to do is be able

0:49:02.560,0:49:08.000
to see each other as equals, that we care
for one another, that our first duty is one

0:49:08.000,0:49:12.049
of care and not of “this must be done
this way.”

0:49:12.049,0:49:18.770
We’re in a very unique circumstance right
now and I think we need to acknowledge that

0:49:18.770,0:49:23.630
and again, see everyone’s humanity. I think
we need to check in with people and see how

0:49:23.630,0:49:30.060
they’re doing. So it’s really helpful. When
I was out on the front lines, a lot of managers

0:49:30.060,0:49:34.490
would talk about, “I have people come
into my office and I talk to them about how

0:49:34.490,0:49:40.210
they’re doing. I get to know them personally.
I speak to them about, what do you need in

0:49:40.210,0:49:42.090
order to be able to do your job?”

0:49:42.090,0:49:48.589
We need to ask our teams that same question,
so what is it that you need? We can’t respond

0:49:48.589,0:49:53.030
to every need, but we can at least hear about
what are some of the needs that you have.

0:49:53.030,0:49:57.040
And managers and directors and leaders also
struggle, and we need to provide support and

0:49:57.040,0:49:58.910
compassion for them as well.

0:49:58.910,0:50:04.670
But I think part of this is a bit of leveling
the playing field and allowing us to see each

0:50:04.670,0:50:11.599
other as humans who all have needs and identity.
And how do we support one another in this

0:50:11.599,0:50:13.590
because we’re all in this together.

0:50:13.590,0:50:17.920
Absolutely. Thank you. And I think that’s
a beautiful note to to end our discussion

0:50:17.920,0:50:18.920
today on.

0:50:18.920,0:50:23.240
So thank you so much to all of the panelists
for participating today.

0:50:23.240,0:50:29.170
I just want to say that over the weekend I
had to take a trip to the ER with my youngest

0:50:29.170,0:50:33.940
daughter, who’s four. Everything’s fine, don’t
worry. But it was the first time that I’ve

0:50:33.940,0:50:38.750
set foot in a hospital since the pandemic,
which I consider myself very fortunate for

0:50:38.750,0:50:41.210
that to have been my case.

0:50:41.210,0:50:46.950
But when I walked in, everything looked different.
There were dividers in between the waiting

0:50:46.950,0:50:52.160
room chairs, and there were nurses in the
full P.P.E. And for me, knowing that this

0:50:52.160,0:50:55.700
webinar was coming up, it was really like
stepping into this world that you’ve all been

0:50:55.700,0:51:02.630
living in for two-plus years. And I have to
say like everyone, every single nurse, doctor,

0:51:02.630,0:51:06.890
healthcare provider that we spoke to, was
so kind to my daughter who was very scared.

0:51:06.890,0:51:13.200
And so I just wanted to say, I see you all
in the audience and thank you so much for

0:51:13.200,0:51:16.299
showing up every day and doing what you do.

0:51:16.299,0:51:20.950
It’s so important. It’s so, so important.
And if there’s one thing that you deserve,

0:51:20.950,0:51:25.500
it’s compassion from the public, but also
from yourselves.

0:51:25.500,0:51:31.270
So that’s it for me today, but before I pass
it over to Margaret to close out, I’d just

0:51:31.270,0:51:35.020
like to also thank our sponsor once more.
So thank you to the Public Health Agency of

0:51:35.020,0:51:40.360
Canada for supporting this important work.
We appreciate you. And Margaret, I’d love

0:51:40.360,0:51:43.200
to pass it to you for some final words.

0:51:43.200,0:51:44.200
Thanks,

0:51:44.200,0:51:49.280
Amy. And thank you for sharing that experience.
And I think what we have seen over the course

0:51:49.280,0:51:54.520
of the pandemic is unfortunately there has
been a real rise in incivility and violence

0:51:54.520,0:51:58.420
towards healthcare workers. I think it’s really
important that we acknowledge that and we

0:51:58.420,0:52:01.990
know that healthcare workers are facing that.

0:52:01.990,0:52:05.380
And I think what you’ve done right now is
exactly what people need to hear. That we

0:52:05.380,0:52:12.420
see you. We appreciate you. We know your service
and your sacrifices and we know your stories.

0:52:12.420,0:52:17.270
And so I think that’s how I think we’d all
like to end this symposium, is to say thank

0:52:17.270,0:52:23.750
you to the healthcare workers and public safety
personnel and other people at the front lines

0:52:23.750,0:52:29.020
of this pandemic. Thank you for your service.
Thank you for your sacrifice and let’s all

0:52:29.020,0:52:35.630
give ourselves a bit of air to allow ourselves
just to, to breathe and be present, and to

0:52:35.630,0:52:42.680
give ourselves that self-compassion that everyone
here needs. So thank you very much.

0:52:42.680,0:52:46.319
Thank you all and thank you all for joining
us today and I hope you have a wonderful rest

0:52:46.319,0:52:47.840
of your day. Take care.