https:/.../2018-11-16_Self_Care_pt2.mp4

>> Hi, I'm Dr. Kirsten Bradbury, welcome
back to Self Care Ethics and Practice,

here in part two, we are going to
talk about the Biopsychosocial model of

health, and continue our exploration
of self care from both ethical and

practical perspectives.

So, let's look at this wonderful starting
slide here that we've got.

I think that's a field of bluebonnets. I
think we may be in Texas, here.

And do, where every you are, where
ever you're watching this from,

know that this is a field of beautiful
bluebonnets.

And that's not an accident. So this
may seem a little wacky that

we would start with something out
in nature,

but of course, as we saw in hour
one, it's especially important for

us to take little pauses and really notice
things that can help us enviromentally

to become calmer, and to just you kind
of regulate our endocrine system

a little bit.

Ah, a couple of little Biopsychosocial
comments to get us started right there

from the beginning.

So, let's look at this overview
for just a second, together.

We've got of course part one in
the bag, we've already talked about

classical ethical principals like
autonomy and beneficence,

and how those things really to undergird
the need for us to be self-care aware

as clinicians.

And then we've got part two,
which is where we are today,

where we will spend an hour talking
about Health Psychology, the

Biopsychosocial-Spiritual Model of
health,

and how it is that I think that
can be really fruitfully applied to

the process of thinking about
self-care, as a clinician.

Then, we're going to move on
to part three, and we'll talk about

the humanists.

Self-actualization and the way
that Maslow's Hierarchy

can be applied to this process
of self-care.

And that's really where we're going
to get into an awesome self-assessment

of how it is that we can really think
about organizing our own thoughts

about self-care. And then in part four,
we're going to talk about some of my

very favorite self-care practices,
again with an emphasis there

on what's evidence based and
empirically supported, to

be able to really be preventive
of clinicians.

So, let's think about this Biopsychosocial
-Spiritual, there's a lot in there,

right?

In fact, it is everything. It is the
theory of everything, right?

So, this is a model that includes
multiple levels of analysis,

and it's important to notice
that these multiple levels of analysis

co-create health and wellness,
so, it would be an illusion for us

to be able to think about any
health topic,

any aspect of your health
and wellness,

whether that's something in terms of
your mental health,

or whether we're talking about your
physical body,

or whether we're talking about
any other kind of health that

you might conceptualize.

This is something that will be
brought to bear by

all of these different variables, right?

So, there is no illness that we
would say is just a biological illness,

that has no psychological, social,
or spiritual component.

Similarly, there's nothing that we
would say is just Psychological.

What on earth exactly that would
mean.

Just psychological.

We don't know, because of course,
the biological level of analysis,

the psychological, the social, and
the spiritual are all present.

And those will all act together
to create a state of health,

or a state of illness.

So whether we're trying to conceptualize
something kind of above the okay line,

right? How well are you thriving.
Or if we're trying to kind of map out

things that are below the okay line,
what's the nature of the problem

or deficit that we're trying to
understand.

Either way, we really want to be thinking
about the fact that all of these elements,

all of these levels of analysis, need to
all be included.

That we can't all leave any of them out,
and still have a complete understanding

of the way that human beings are
functioning and operating.

Ah, human beings. Hm, did you realize
that clinicians are human beings too.

So, this is definitely one of the big
messages of course, of the

self-care process, and the idea
that we really want you to become

dedicated to your own self care,
is that you're a human being,

and as a human being, you're
going to have a lot of needs.

That's just the way it is.

So, let's think about our
biological needs first.

When we think about the
Bio aspect of Biopsychosocial,

this reminds us to think of ourselves
as embodied biological entities.

We really want to be thinking
about the fact that there's kind of

nothing that you can do that's not
biological,

because you are a biological being.

And so anything that you would try
to do, you know, I challenge my

undergraduate students sometimes
to come up with examples of

non-biological behaviors.

And no matter what it is that you're
thinking about,

even if it's something where
you're imagining something.

All that's happening in your brain,
right?

Everything has a biological component
to it.

We don't know how to do anything
non biologically.

That, I'm afraid, will get us very much
into the spiritual component of what

we're talking about, is we can't transcend
our biology, in any known ways, so far.

So, we have lots and lots of biological
needs,

and these biological needs are really
fundamental.

We have to attend to them, in order to
be able to function really well,

in that Biopsycho-social-spiritual way.

You can't kind of put off your biology,
there's no way for you to

actually say like "Ah, I don't need
to drink any water today,

I don't need to breathe any air
today."

Actually, it turns out that some
of these biological needs are

among some of our most urgent needs,
and are among the needs that we have

to maintain really frequently, right?

On a continuous basis.

So, biology is really fundamental
to all the other levels of analysis also,

in order to really understand our
psychology,

we need to be able to understand some
of our biology, in order to be able to

understand ourselves as sociological
creatures, also.

We really want to be thinking about
the way that our biology works.

So, it's not an accident that we are
mammals.

Being mammalian is definitely
going to be part of the way that we think

about what kind of self care we're
going to need, right?

So notice, that this biopsychosocial kind
of way of thinking about self-care,

unlike just this sort of classical
ethical principals

that we reviewed last time,

the Biopsychosocial model actually starts
to turn us towards the "how" of self-care.

The ethical perspective that we took
last time, in talking about beneficence

and non-malfeasance, that ethical
perspective really shows us the "why"

of self-care. Why is it that we really
need to attend to our self-care.

Why is it important for us to make
sure that we actually do those things,

that we fulfill that need, that promise
to our clients, right?

And we talked about the fact that this
is an ethical need.

However, it doesn't really tell us a lot
about how to take care of ourselves,

right?

That isn't part of that mandate. It just
in sense says "It's got to work."

You've got to take care of yourself
well enough that you are available

and consistent.

Well, okay. This model allows us
to start to dig into what we would

really need to be thinking about
needing to do.

So, food and water, obviously.

Routine physical activity.

This is something that we absolutely
have to be thinking about,

and it's something that frankly,
many of us are not great at

accomplishing. So we need to think
about from a health psychologist

perspective, I really think about how
it is that we can encourage more

routine physical activity for people.

And this of course includes my colleagues
and myself.

We're not exceptions to this need.

Then of course, freedom from disease.

So notice that wellness is of course
more than just the absence of disease,

but it does include the absence of
disease.

Um, we need to stay well.

In fact, one of the big disadvantages
of being too stressed out over time,

is that that can really impact your
immune system, and can make it

much more easy for you to get sick.

So things like viruses and other kinds of
minor communicable diseases,

really are very different in terms of
how much at risk you are for having to

do things like miss work, or just not
enjoy your day, right?

Because you're sick.

So one of the things that we're really
talking about here is - what are those

fundamental, biological needs,
that if we can attend to them,

if we can try and find ways to
keep ourselves well, that we'll actually

be able to really think about that in
terms of our self care, right?

In terms of being able to be more
accessible and available to our

clients and to the other people who need
us in their lives.

Ah, sleep. Uh, you know, we could spend an
entire hour or more talking about sleep.

Sleep is a really fundamental tool,
because it is such a fundamental,

biological need. Um, you know,
psychophysiologically, you absolutely

have to have enough sleep.

Now how exactly we define enough
sleep, that gets a little bit tricky,

but I can tell you that if you're sitting
there thinking to yourself right now,

"Oh, I'm one of those people, I don't
really need much sleep,

maybe four hours a night, I'm good."

It's possible, there are a few people
out there like that, but it's very

unlikely. It actually turns out that most
of the people out there who think that

way, about themselves, that that's
not accurate.

That actually, your performance is
being impacted by the lack of sleep that

you get.

And this is true even if we're getting
enough sleep, but it's low quality sleep,

also. So, sleep is definitely something
that many of you will be

very well versed in. Partly because you
will have had to help a lot of your clients

with sleep related problems.

As we know, sleep is very stress reactive.

It has the tendency to get disregulated
and disrupted by lots of behavioral and

physical things, as well as psychological
things, right?

So, we know that it's a really tricky
one to maintain. A really high level

of self-care.

But that doesn't mean that we're off the
hook. That just means that we need to

acknowledge that that's part of
what we're dealing with.

We also have to have contact with
other humans,

hopefully you're not existing in solitary
confinement.

This is not healthy for people.

And we have not just a psychological
need to be around other human beings,

but also a biological and physical
need to be around other humans.

So, it's very important that we have
regular exposure to stimulation for

all of our sensory motor neurology,
in order to have a very basic care

right?

Bear in mind, we're talking about
some of our most fundamental needs.

You absolutely can't just live in a box.

You have to have lot's of things that
are actually there for you to see

and there for you to hear, and there for
you to touch, and there for you to

interact with in the world.

So, we have to have all of this behavioral
maintenance of our physiological

regulatory systems.

Right?

So our circadian system. Anything that
is regulatory, right?

We have to constantly be thinking about
maintaining those things from a

behavioral perspective.

Even though it's a biological set of needs.

Right?

So when people say that they're
disregulated, a lot of the time,

I think they mean that they haven't
actually been taking care of themselves

consistently, right?

And there are a lot of different reasons
for why that happens.

But certainly, those of us who work
with clients, we know that this is

something that they experience lots of
times.

So, why it is that we would think
that we're any different, I don't know.

But we're not. It turns out that actually
we can experience a lot of those

dis regulatory impacts also, if we don't
take care of ourselves.

So, if you've ever found yourself up in
the middle of the night,

not able to sleep, um, either because
you're stressing out, or you're just

wide awake, you might know that that's
a little bit of one of those

circadian moments, right?

You might be able to empathize with
your clients who have sleep difficulties

in those times.

So, last, but certainly not least, we
have a biological need to relax.

So, remember that the relaxation response
is a physiological response.

It's not just when we say "go relax",
that we actually mean just like

relax your mind, and don't feel so
stressed out psychologically.

We actually are talking about the way
that your physical body responds to stress

and the way that your physical body
can choose relaxation.

So, know that of course the relaxation
response and the stress response are

incompatible. And this means that if
we can manage to get ways for the

relaxation response to actually be
triggered,

that the stress response has to dial
itself back down while you're relaxed.

So, know that this is one of the
mechanisms that we use to really

tap into our self care.

To really say like what is it that we
need?

What does our self-care need to be
comprised of?

What needs to be in there?

And in fact, ways to relax are going
to be one of the most important

things that we actually have to look
at in terms of our self care.

So, when we think about relaxing,
we either want less stress,

we want better stress, we really
might be good managers of stress.

I put a question mark here, partly
because I really want us to all be

thinking about the fact that there is
a ton of research now, that is out there

about stress, and about the way that the
relaxation response works,

and about the way that the stress response
works.

So, our stress is different at different
times,

our stress response is
not always the same.

And how we conceptualize our stress,
how we think about stress, has a huge

impact on what it does to us
physiologically.

So your stress is actually much worse
for you if you believe that it's bad

for you, for example.

And your stress is much worse for you,
if in fact you're treating

all of your stressors as things that
are really threatening to you,

as opposed to challenges, right?

So if you can kind of think about
your stressful situation as being

one that you need to really climb
a mountain in order to solve it,

or there's something that you need
to do to make this better,

You know, this can actually really change
the way that the stress hormones are,

in terms of impacting your body
as well as your mind.

So, there's a lot about self care,
that really does tap into the

biological, into the physical needs
that humans have.

Alright. So, the next thing that
we're going to do is pause just

for just a second, to be able to
run our retinas over a thing of beauty.

Being able to acknowledge, if you
look at this beautiful picture of

sunflowers, with me. Being able
to acknowledge that we have to -

you know, beauty has a function.

Okay, so, looking at beautiful things,
looking at things that kind of,

that we find aesthetically pleasing,
is something that can really

actually help you to relax.

It can help you to unwind, to focus
your thoughts on something positive,

and being able to focus your thoughts
on something positive, of course,

will also tap back into this biological
system that we're talking about.

So, if in fact, you find yourself
feeling stressed, and tense,

well, you might want to take a few
minutes to think about

something not stressful.

To think about something that's
going to help you to feel better.

And I like looking at these sunflowers.
They're just cheery, right?

They're just really fun and pretty
to look at, and I think about

what are those people
doing in the tents?

What are they doing walking
down that pathway?

It's just kind of fun to sit for a second
and think about that.

And notice that when you do that,
the more you can give yourself

entirely into one process, one thing
to really focus on, this is an

aspect of our work, you know,
that could actually be

very beneficial to practice, is being able
to compartmentalize, being able to say,

"Now is not the time for me to
worry about that client.

"Now is not the time for me to think
about that fight that I had with my

"brother the other day, now is not the
time for me to be thinking about

"these stressful things. Now is the
time when I'm choosing to think about

"something else, when I'm choosing
to dial down my stress response

"and calm my body down, so that
I can take a break from those

"kinds of negative things, so that
I can take a break from those

"impacts and stresses on my life."

So, we will say goodbye again
to the beautiful sunflowers.

And they'll be back to look at some
more fun things like that,

you know, throughout the time that
we have together, throughout the course.

I want to make sure that we are
really noticing those things

and taking a minute to really talk about
how it is that we can in a continuous way

not just in a reactive way, but in a
continuous way, in a proactive

and preventive way, that we can go ahead
and really incorporate self-care practices

into our daily lives, that they don't
have to be things that are

enormously disruptive, or that kind of
take over when you're like

"I'm too busy for self-care."

Oh I promse you're never
too busy for self-care,

and the more you feel like
you're too busy for self-care,

probably the more self-care
would really benefit you,

and would actually really help you
to be able to dial back that

sense of being overwhelmed and that
sense of having too much to be able

to manage and juggle.

I tell people all the time that I have to
have a very large capacity, right,

that the way my life is designed,
I have lots of heavy lifting

that I have to do, lots of big deal
things that I have to move around,

important stuff that I have
to think about in ways

that I have to help people,
and I need to be able to be

consistently available, I need to
be able to be present,

I need to be able to be mentally
there and on, and that requires

actually a lot of maintenance,
and I could go ahead and deny

that that maintenance is needed,
but all that would happen is that

that would catch up with me
in the long run, and instead,

what I'm here to do is to try to
really proselytize this idea

that what we want to do is fundamentally
put in place the behaviors that are

going to help us to not actually burn out,
right, and to not have times when

we're like "I can't even do my day,
how am I going to be able to

"get through this entire day?"

The way you're going to be able to
get through this entire day

with all these different things in it
and all the different needs

that everybody has by actually
taking us, by taking care of yourself

originally, by being able to say
"I'm going to fundamentally

"put in place things that are going to
allow me to be the biggest, best,

"strongest version of myself
that I can possibly bring to the table."

I don't expect people to be able to
run marathons withou training.

Similarly, the way that you are training
yourself into the way that you work

is going to make a huge difference
in terms of what you're

capable of doing.

So, let's think here together a little bit
about these psychological needs

that we have, so the psychological needs
when we think about these, right,

like biopsychosocial, okay, psycho
comes in the middle, right there,

and the psychological needs are
in fact things that we could

think about as having biological
components and having

social components, they often have
an intrapersonal component, right,

something cognitive, something
emotional, right, what's going on

with the person there.

And bear in mind that these things
are not meant to be expressed

as being separate from, or distinct
from the biology of the social

level of analysis, but in fact, these
are just ways for us to be able to

think about things and divide things
up so that we can conceptualize them

more effectively, but psychological
things are obviously also

biological and also social.

So let's look at this slide together.

Our psychological needs do of course
include our physical health, right?

Our social health, these things
are not-- and our spiritual health,

these things are not divorced
from our psychological needs.

And in fact, if you have physical
illness, or if you're having

cultural difficulties, if you're having
a culturation issue, if you're

having some other thing
going on in your

social or cultural level of analysis
that's really unhealthy or

impacting your badly, or if there's
something going on in your

spiritual life that's really detrimental,
these will also be things that will

impact you psychologically.

So it's very important to realize
that these things are just very connected.

Right? And it's really a nice aspect
of the fact that they are connected

that we can go ahead and then
intervene in lots of different elements

in order to be able to get all of
those different kind of impacts.

All right? So, we also know that
we have a psychological need

to interpret our experiences, right?

So humans like to make meaning,
we have this need for narrative,

we have a need to have a self,
right, a sense of identity.

The fact that we're sort of, you know,
building a narrative for ourselves

in terms of what our life is about,
what our life is like,

we have the need to
decide for ourselves.

We have the need to think
and experience with others,

that's a need for social cognitions,
notice that that's again,

one of those psychological needs
that's very tied into what the

other levels of analysis will
bring us in terms of our understanding.

We have to have a variety of
purposeful activities,

I think this is a really important
element to think about

when we're, you know, kind of
talking about just basic

human psychological needs.

We need to be interested in things,
and we need to have a sense of purpose,

and we need to be able to do lots of
different interesting stuff. Right?

And so I think we also really need
new things to learn, we have to have

access to new information.

One of things that I find makes me
happiest is being a lifelong learner,

right, being able to learn new things
all the time, whether that's

going back to the research base
and really learning things that way,

or if its by talking to other people,
I learn things from my clients every day,

I learn things from my students
every day, and I feel like

that's one of the most psychologically
satisfying kinds of aspects

of my existence.

It's really important to notice where
it is that your psychological needs

are being met really effectively,
by the life that you lead,

and where your psychological needs
are not being met by the life

that you lead.

So we do need and we are all perhaps
a little bit noticing of this these days,

we all need an illusion of control,
and I do put it as an illusion.

We don't actually need to control
very much as human beings,

but we need to think that we're
controlling stuff, so there's all kinds of

literature out there about how it is
that when we take the illusion of control

away from people, that it makes them
very uncomfortable and it definitely

causes us lots of stress.

So, if in fact you're having issues
related to control, this is also

something that can kind of
impact our psychological needs,

and increase our need for
psychological self-care.

So our values, right?
What are our values?

Our values connect us to that
spiritual level of analysis,

and definitely many people would
tie that to the concept of the soul,

and that your values are not just--
they're moral, right, they're a big deal,

they're something that aren't just
kind of a daily issue, but instead are

something that may transcend most of
the mundane aspects of daily life,

and may even for you in your belief
system, may transcend all of our

worldly aspects, and may be more
important than any of that.

So this is also a psychological need that
many human beings have, is to feel

connected to something larger, right,
to have some sense of value in that.

Now, we also need downtime.

And this-- when I'm talking to my
colleagues, I know that on some level,

I'm preaching to the choir here.

All of you probably tell your clients
many times that what they need

is more downtime, that they need
more balance in their lives,

they need to dedicate more time
to the things that are really

important to them,
that kind of thing.

Well it turns out we need to
do the same thing,

that there are lots of times when
we would say "Doctor heal thyself,"

you know, kind of look inward and say
are there things that you are doing

in your own life that if a client
were to bring you those things,

you would say "Oh, well
there's part of the problem.

"They're not sustaining themselves
with the way that they

take care of themselves."

So we've got to have downtime,
we have to have a time to

imagine things, to create things,
to invent things, to actually

do things that aren't just the
day-to-day sort of demonstration

and performance aspects of our lives.

And that's something that, you know,
in this very work-oriented society

that we have, can be
a little bit tricky sometimes.

All right, so I know that this is
one of the places where I was like

"Let's take a little minute to say
okay, biopsychosocial, wow."

And then spiritual, we have to
include this too.

Bio, psycho, social spiritual.

How do I want to think about it,
if I were doing a little self-assessment

for myself, how do I want to
think about how well I'm actually

attending to the particular different
categories of need that I might have?

And the biopsychosocial model really
allows us to think about not just

bio, psycho, and social,
and spiritual, and it does that,

those little four elements.

But also it kind of helps us
to think about how those

different things connect, and if there
are ways that we might be able

to find overlap.

We're going to talk a lot more
about that in a few minutes.

First, let's think about our social needs,
right, let's look at this slide that

we have listed lots of social needs,
and there are lots of others too,

so there might be many that
did not make the cut onto this slide,

but we have a need to have
close relationships, right?

We have a need to contribute,
and this means, you know,

basically to contribute to the
needs of a group or to the

needs of other people.

And notice that this is a social need
that most clinicians have met

in themselves in spades, right?

We definitely contribute
to the needs of others.

But, we may not always feel like
that allows us to have enough time

to sustain our other social needs,
it could be that we do too much

of that, when (inaudible) that
doesn't leave enough

time for some of these others.

We need to feel like we're
protected by a community.

One of the social needs that
we have is sort of a social need

for safety, not just our physical
safety, but safety of our ideas,

and being able to feel like
we are a part of something,

and that it is safe and
that we belong there.

We also have a need to feel
heard and understood.

And I think it's interesting, and I
thought about putting this

in the psychological needs,
but you can't really be heard

and feel understood without
other people, right,

and so I think of this as being
a real social need that we have,

even though it's a psychological
need too, it's a really good

example, I think, of where it is
that we would think about

those levels of analysis
really coming together,

and saying "Well of course,
it's a psychological need

"that has to be served in a social way,"
or "It's a social need that has to

"land psychologically." Right?
Either way you kind of think about that.

It has both elements inextricably
involved in it, right?

So we need to connect other people,
we need to be able to find

common ground to be able to feel like
there are others who understand this

and understand our ideas.

We need to be able to express ourselves,
and this is one of the things that I know

we find very important in terms of
remoralizing our clients,

there are lots of times when what we do
is help a client find a voice,

find a way to express what's
been going on to them,

both expressing directly to us
as clinicians initially,

and then also expressing themselves
more fully out into the world

so that they have a better
social experience of life.

Well, this is one of those places,
too, where we might think,

"How much am I getting to
express myself? How much do I

"actually share myself with others?
I've become a very solid listener,

"I do a lot of listening to
other people's stores."

Do you ever get to tell your story?

Is there a way in which you have
met that need for yourself as well?

There's that need to listen,
we definitely meet that one too.

And then there's the need
to love and be loved,

and I think it's just really important
for us to just make sure to

put that on there, you know,
we are human beings,

human beings need to be cared for
and need to be loved,

and if you think of yourself as
someone who doesn't

require any care, right,
I know lots of clinicians,

actually, who are very committed to the
idea of being low-maintenance people,

"I'm a low-maintenance person,
I don't really need anything,

"I can just kind of keep going,
I grab a little quick something to eat,

"And I grab a few hours of sleep,
and I'm just, you know.

"I don't really need anything.
I don't know when the

last time was I did
something social."

I've heard my colleagues
say that many times.

And I think that they find a certain
pride, actually, in running themselves

a little ragged, right, and being
able to say "I don't meet my needs,

"and yet I'm fine anyway."

I think that's one of those sort of
existential concerns that we could

probably get into a lot of the
philosophy of where exactly

that all breaks down, but that
it's really important for us

to remember that no matter how much
we deny it, we really are humans,

and we really do need to
attend to our needs

in the same way that we would
expect anyone to attend

to their needs, that sometimes
we make kind of a weird exception

for ourselves in thinking about
the fact that maybe we're special,

maybe we don't actually have
all these same needs that

everybody else has, when really,
I think we do, I think there's

good evidence that when we
don't take care of those needs,

well that's when problems like
compassion, fatigue, and burnout

and all the different issues
that we talk about there,

lots of avoidant coping, right.

These things are-- we're at
real risk for these things,

and I think partly the reason that
of course clinicians are at risk

for these things, is that we
aren't taking care of ourselves

as well as we could or
perhaps even should.

Right? I try to reserve shoulds for
when there's a moral component, right?

For when we would say "Hey, don't be
tyrannical with me there shoulds,

"Is this is a place for a should
in my life, do I actually

"have a moral sense that this is
something that should happen

"in a big way, right, and if it doesn't,
something moral has gone wrong?"

And I do believe that, I think that
this is a place where when we're

talking about self-care, that's a place
where probably a should and maybe

has a little bit of room, right,
where we would say

"Well yes, actually, there's an
ethical basis to why it is

"that I need to be able to
take care of myself,"

and in some ways, if you kind of
turn it around for yourself in this way,

you might think about it this way.

Here's my positive reframe on this,
I get to have a job where I

have to take care of myself.

I have no option.

If I don't take care of myself well,
I won't do my job well.

And in a work-oriented society,
frankly that's kind of the only

good excuse that I've been
able to find for why it is

that people should take
care of themselves.

Right? In a work-oriented society,
we're really encouraged to sort of

dash ourselves against the
rocks of our careers.

They really want you to think about
the fact that when you've chosen

a helping profession, well perhaps
one of the small advantages

to having chosen a helping profession
is that now you have a really

"good excuse," you've got a
"really good reason"

for why it is that you would say
"No, my needs have to be attended to.

"Otherwise I don't have anything left
to attend to everybody else's needs,

"and that's my job to do that."

All right, so let's look at this
slide about spiritual needs.

Spiritual needs are a little
bit tricky, right?

So the reason I say that is just
because I'm a psychologist,

right, so the realm of the spirit
is definitely something

that, you know, I was not as
well-trained in, because it's not

sort of this scientific realm, right?

It's not something where I'm here to
say that either God exists or doesn't,

or what type of god there is,
or anything like that,

we can leave all of that aside
in terms of just thinking about

what these sort of spiritual needs
are that human beings appear to have.

And luckily, psychologists, we have
allowed ourselves to study

how it is that people respond to
spirit, and to the spiritual needs,

and how that operates, and we know
that spiritual coping, for example,

is a very important form of
coping that many people,

including mental health professionals,
need to be able to rely upon

in order to be able to cope
with really difficult things

when they come up in life.

So I think it's undeniable that we
really do have some spiritual needs,

however it is that you might
conceptualize those,

some people would think of this
as being some category of

our psychological needs.

In the way that I conceptualize this,
there's really no need for us

to have to distinguish those,
for us to have to say

"Well, but is it a true
spiritual need or not?"

These are just convenient categorizations.

All of these are just convenient
categorizations that we use

to be able to understand the ultimate
complexity of what we're dealing with.

And it's a very complex thing
to be a human being

and to try to figure out where
all of the human beings' needs are.

So I think of this as being an
organizational heuristic, right?

Biopsychosocial, spiritual.

There's an organizational heuristic,
a way of organizing something

that allows us to then be able to say
"Oh yeah, I can kind of conceptualize this

"a little bit more clearly."

So I find it useful to think of
these as spiritual needs.

One of the spiritual needs that we have
as human beings is also one that

we mentioned under psychological needs,
and that's a need for purpose and meaning.

What's important to you?
What matters in your life?

Why are you here everyday?

What gets you up in the morning
and makes you think,

"Yes, I'm going to run
up that mountain."

What are the things that
actually motivate you?

And a lot of the time, having purpose
and meaning in what we're doing

is incredibly important, and it's one of
the things that people report

when you do get burnt out and
along that road to burnout,

one of the things that happens is that
you lose the sense of having

that meaning in your work.

You lose the sense of that fulfilling
purpose of your work, and so notice

that this is also a place where we would
say attending to one's needs

may proactively help us to prevent
those issues that can come along

that then build up to a place
where we can't be competent anymore

at the helping that we want
to be able to provide.

So, gratitude, I think of gratitude
as being a spiritual need.

I think the positive psychologists
have done a great job of

helping us to see how important
gratitude is, and that when

people can experience gratitude,
and can have gratitude,

whether that's gratitude for
other people, for a spiritual being,

for anything, right?

Just that sort of thankfulness,
that sense that we have of

"Oh, I'm so glad, I'm so appreciative
that I get to have these things

"in my life."

The more that we can do that,
well the healthier and happier we are.

And this is true of many people,
of course, including clinicians.

So one of our spiritual needs
is to be in touch with nature.

Nature is definitely a place where
we could talk about having

biopsychosocial spiritual needs,
and being able to kind of

choose where to put nature
on which of these slides

in many ways is artificial,
because we actually do need

to have contact with
the natural world.

We are part of the natural world,
and we've done a whole lot

to surround ourselves with the
trappings of non-nature, you know?

Here I am in a studio, in the middle of
a big campus with lots of machines,

all kinds of things around us,
right, and nature might seem

very far away.

Which is one of the reasons why
it's so important for us to incorporate

small bits of contact with nature
into our daily lives, and this can be

a real challenge for those us
living in urban environments.

So, it's something that I think
we need to elevate that

up a level of a spiritual need,
partly so that people will really

pay attention to how
important that is.

And do you think that we have a
need very often to be in touch with

something greater than ourselves?

That that's something that's been
shown in a lot of different

spiritual practices, to be
really helpful to people.

I think that spiritual needs include
the need to have values,

and that many people consider
their values to be based,

at least to some extent,
on their spiritual beliefs.

I think that we have a need to
extend beyond our mortal life,

right, like there's this existential
kind of need there, to be able to

transcend our biology.

We have not been able to figure out
ways of doing that in this life, right?

We don't transcend our biology well,
we're really stuck in these bodies

and what these bodies need.

And so very often, one of the sort of
psychospiritual needs that people have

is to feel like they can extend
themselves beyond this,

beyond this small timeframe
that we have to be

mortally present right here.

And that very often, that's one of
the needs that spiritual practices fulfill

right, is actually that need
for existential reassurance.

Is there something more to this,
is there something beyond

just the sort of daily grind
that we're experiencing?

And however is is that you
conceptualize that,

whether you think of that as being
something beyond this life,

or if you think of that as being
something that you need to

manifest and make real every day
here on this planet now,

either way, you're going to want to be
thinking about this as a set of needs

that you have that you will want to
make sure to be meeting.

All right, so spiritual needs,
there we go.

Now we're going to look next
at a slide that talks about

different types of self-care,
but before we go there,

I want us to just kind of think,
just already, just for ourselves,

about what these different
types of self-care might look like.

So because we've already talked about
the fact that these things are connected,

and we're going to talk about that
much more in just a few minutes,

but I guess we've talked about
the fact that these things are

interconnected, right, these different
levels of analyses do not

exist in isolation.

It's not like we're just like
"I'm biological right now,

"and I'm going to go be
psychological now for a a minute,"

"Now I'm being social."

No, in fact, it's a holistic
sense of the person, right?

That person is always experiencing
things in a biopsychosocial spiritual way.

So, the different types of self-care that
we're going to kind of talk about here,

they map on partly to these
different levels of analysis.

But one of the beautiful things
about this is that we can

access these from lots of
different perspectives, right?

So let's look here at these different
categories of types of self-care.

We've got physical self-care,
all right, that's one type of self-care

that's shown on this slide.

We've got physical self-care,
and we've got mental self-care.

And physical self-care and
mental self-care are going to be

very closely aligned, right?

When we think about what are the
benefits of taking care of your

physical body, well one of the benefits
of taking care of your physical body

is going to be things like
"I can concentrate better,

"I've got more mental clarity,
I'm able to get a train of thought

"going that's really useful,"
et cetera et cetera.

There are many different
things that we do mentally

that are actually really dependent on
how it is that we're taking care

of ourselves physically.

So physical self-care is not
to be underestimated

in terms of its importance.

And then mental self-care, of course,
is something that we also want to

engage in deliberately.

So a really great example of mental
self-care would be how you

attend to your self-talk.

Now self-talk of course is a variable
that as clinicians, I'm sure that

we're all very familiar with it,
and that in fact you talk to other people

about their self-talk
probably pretty often.

One of the things, of course, that we know
is that positive self-talk, supportive

self-talk, the way that you
talk to yourself about yourself

and if you're positive about that
and supportive, that those things

can help to prevent people
from being depressed,

and that in fact, depressive thinking
includes a lot of negative self-talk.

So this is just one simple example of the
way in which we want to think about

how it is that we give ourselves mental
self care.

What kind of maintenance are we actually
doing.

Are you deliberate in any way about what
type of thinking you have?

Do you direct your thoughts? Do you
direct your self talk, in ways that would

actually be beneficial, that would
actually support you.

Or are you kind of getting away with a
bunch of stuff that we would say

"Oh, if I saw that in a client, I'd be
like "Gosh, I bet this is part of why

you're experiencing these depressive
episodes", or some other kind of anxiety

or other kinds of emotional responses to
negativity and their thinking.

So. Mental.

Alright, now we've of course got
emotional, emotional self care is very

important, and notice that emotional
self care could be thought of as

doing things that are emotionally
positive, right?

But it could also be thinking about doing
things that help you to regulate your

emotions, right?

So it doesn't necessarily have to be the
case that the particular behaviors that

you're engaging in, would actually be
in the same channel as the impact that

you're looking for.

So, for example, you could go ahead and
do something that was very cognitive,

but that allowed you to engage more
in emotional regulation.

Right? So an example of that, for example,
would be thinking about one thing

at a time, right?

So, doing anything meditative that allows
us to just literally focus on one thing.

Try to focus on one thing, and any time
something else kind of comes in the way,

try to let it go, and return your focus
to one thing.

This is definitely a practice that we
would say isn't an emotional practice,

it's not an emotional activity, per se,
but it is something that helps to develop

emotional regulation.

It helps to support people in their
efforts to control their own emotions,

and especially the volume, or tenor, this
sort of size, or intensity of

those emotions.

So, an example of emotional self care.

Then of course we've got social. Social
being of course one of these levels of

analysis, but also a type of self care.

I think many of us go to social self care
as one of our first ways to support

ourselves, when we're thinking
" Oh my gosh, I need some more self care"

One of the things that sometimes think
about is "Maybe I need to spend some time

with friends, maybe I need to do something
social."

Maybe I need to get myself a little away
from work, and into my social life.

And notice, that this is one of those
sort of levels of analysis that pops up

having to do with the fact that we
actually do have these two sides of life,

right?

That we have this work life balance.

And a lot of the time, when you're talking
about work life balance,

well, the life that people are talking
about is very social.

It has to do with their relationships with
people outside of their work place.

So, notice that this is one of the places,
where hopefully you're already giving

yourself a little bit of self care.

And it's also probably a place where you
might have the potential to increase

what you're doing there.

I am here to give you full permission to
explore and make sure that you're taking

full advantage of all those wonderful
social relationships in your life.

It turns out, it's not selfish for you to
do that.

And that in fact, you need to be able
to do that, in order to be able to take care

of the other people that you're
responsible for professionally.

So, there you go.

Practical self care is also a - I think
a bit of an underemphasized form of

self care in the literature.

It's something that we emphasize a
lot with our clients, especially if

they're somewhat lower functioning.

But that we haven't seen incorporated
as much into sort of the self care

practices for clinicians. And I think this
is something that we have a little bit

of room to grow.

Because frankly, I know lots of people who
could really benefit from some more

practical self care.

Things like practical self care
include things like

how well are you attending to your
schedule, right?

And like is it the case that you've got
like transportation stresses,

and very practical stuff, right?

Like how is the sort of way that you
have your day pragmatically organized,

how is that impacting you?

Is there a way that you could go ahead
and support yourself more effectively

through some kinds of practical coping.

Right?

And then last, but certainly not least,
we've got spiritual self care,

which we've already just finished talking
quite a bit about.

But is something that can actually be
accessed, right, in the same way that we

talked about all these different levels
of analysis.

Spiritual self care can be accessed
directly

by doing things that we would put sort
of in a spiritual category, right?

We'd say okay, I attended a religious
service, or I did something that was

deliberately intended to put me in touch
with my higher power.

Something along that line.

Or, we could go ahead and do something
that helps to support us spiritually,

that comes in from any of those other
channels.

So, for example, sometimes, if one
of your values, for example,

is that you need to be able to spend
considerable time, say with your children

and that's value based, when you do then
spend time with your children,

what will happen is that you have a better
sense of "Oh, yeah, I'm taking care of that

spiritual aspect of myself."

I'm tending to my values and making sure
that my life is in keeping with the things

that are actually major and more important
to me.

There we go. Those are some types of
self care, and

the way that those things relate to
biopsychosocial-spiritual coping.

Now, here we are, thinking about this
biopsychosocial spiritual.

And I've talked for quite awhile now about
what this overlap is about, and the fact

that there's this cross over, right?

There's this communication between these
two - between these four levels.

right?

So, what I'd like to do now, is just draw
us a little diagram, so we can see this

quickly.

I almost went to draw it with my
regular pen.

That won't work. We're going to draw it
with this special pen.

That's what we need to be able to do.

Alright, here we go.

Bio - I'm just going to put
bio over here.

Put psych over here. Let's go social
over here.

And then the spiritual, right here.

Okay, now of course those could
have gone anywhere.

Those could have gone anywhere,
but the important thing about this

sort of non diagram diagram so far
is where the arrows go, right?

So what influences what?

Does bio influence psych?
Absolutely. But psych influences bio also.

Now, does psych influence spiritual?
Yes. And spiritual influences psych

as well.

Similarly here, we've got a reciprocal
arrow, they go in both directions.

Same thing here too.

And then um, I think we're going
to need a couple of more arrows.

Even though it sure looks like
we've got lots of arrows already,

the fact is that all of these levels

of analysis influence all of the others.

So, notice that we've only got kind
of four categories.

It's really kind of a simple model,
right?

But the - what complicates it is
all these arrows, but in fact,

all of this reciprocal action, all of this
reciprocal influence is really important.

And is in fact, one of the things that
those of us in health psychology,

find most helpful in terms of trying
to be able to help people,

with all of this.

So, when we look at this slide
about crossover and overlap

that shows us we have
the crossover, the overlap,

we've got communication
between the levels.

This is in fact a basic premise
of all systems theories right.

And this is a systems model,
the biopsychosocial

spiritual model is a
systems model.

And in any systems theory
we would say that

these various levels of
analysis influence one another.

Well the beauty of that
of course is that then

much as we talked about
having to do with these

different categories
of coping and

different categories of
self-care is that

one of the things we can
look at is the fact that

one action may in fact
influence all of these

different levels, right.

So there are some practices
that we would say are

biopsychosocial
spiritual practices.

And just in and of themselves,
they will actually give us

kind of everything that
we're looking for.

So, there's the question.

This biopsychosocial
spiritual model,

it leads us to this question.

How can we use our
behavior to influence

our biopsychosocial
spiritual health?

And in fact, we really can.

So, an example--
we're going to look at

some examples of
connections between

biopsychosocial and
spiritual but one first,

right off the bat, one type
of behavior that we

would really look at there
would be yoga.

So the practice of yoga,
for example,

is one that we can really
think of as being

a biological practice,
right it's a physiological

thing that you do.

But it also has psychological,
social, and spiritual

components to it that allow
it to actually be very much

a mind body practice that
actually influences us at all of

these different levels and
can help to support us that way.

So this is one of the reasons
why yoga has become

a very popular type of
self-care.

It's because it's actually
is very efficient.

It hits a lot of these different
things that we're looking for.

So, let's think about
some others here.

Some of these examples,
I think, are among

the most important things
that we have available

for us to think about
because they will allow us

exactly to think about how
to make our self-care

most efficient.

And I know that for me,
with all the different things

I have going on in my life,
and all the different

responsibilities that I have,
it's particularly important

that my self-care really does
get the job done (laughs).

And that it tries to be
something that is efficient.

So, hostility and
social support

and heart attacks.

This is some old data that's
been well supported

over the years.

Replicated many times.

It is the case that hostility
is really dangerous to you

in terms of your
cardiac life.

So, if in fact hostility is part of
what you're dealing with,

then you probably want
a lot more social support.

And social support can
help to reduce hostility,

and reducing hostility
can protect you from any

kind of cardiac damage.

Now, this is related, this
sort of cardiac damage stuff is

closely related to one of
my very favorite things,

and that's sort of these secrets
of the stress response.

Right, so I of course
am not the first person to

talk about these things.

Many people have
talked about them.

There's a wonderful TedTalk
by Kelly McGonigal

for example, that talks about
making stress your friend.

And one of the things
she emphasizes,

and that many other
researches have emphasized,

is that oxytocin
as a hormone,

is also a stress hormone.

Right, so we know it
as a cuddle hormone,

as a feel-good hormone.

But the important thing
here is that when

it's activated as part of
the stress response,

when you respond to stress,
by creating Oxytocin,

this is protective in terms
of your cardiac health.

So this is one example
of how it is that

this can work.

So, now that we're talking
about Oxytocin,

let's go ahead and
take a fun break

and look at a little (hums)

a little video that we
created about Oxytocin.

♪ (guitar) ♪

>> Self-Care Tool Kit.

>> Hi, this is Dr. Bradbury
with another edition of

your self-care tool kit.

Today, I'm here with
a whole bunch of cuteness.

to talk to you
about Oxytocin.

Which is a wonderful
hormone that

you want more of
in your life.

This is Althia
and this is Elle.

And this is Kennedy.

And we are here today
to tell you if you cuddle,

if you hug,
if you love,

if you snuggle with
little animals like puppies,

or if you get hugs from
kids that you love,

that in fact you cause your
brain to give you more Oxytocin.

And Oxytocin is a
hormone that

makes us feel good.

It's the love hormone.

The cuddle hormone.

The hug hormone.

But it's also important to
remember that Oxytocin

is a stress hormone.

And if in fact you can
get access to Oxytocin,

if you can cause it to be
present more in your body,

then you'll be able to
actually handle stress

better everyday.

So, get some Oxytocin
in your life.

And remember there is
a purpose to all of

this love and cuteness
and cuddling.

That it will really actually
help you to manage

your stress.

(laughs) Right?

You're going to help me
manage my stress?

(chuckles) How cute is that, right?

>> (giggles)

>> Alright, give me a
big hug guys.

There goes Kennedy!

(laughs) Thank you.

This has been another
edition of your

self-care tool kit.

>> Aw that was really cute.

I had a lot of help with that
video, that's for sure.

So, you know,
just hopefully this helps

bring home for you
a little bit.

And know what we really
want you thinking about

in terms of taking care
of yourself, right.

Oxyticin is-- it is
within your reach.

You can go get some!

(laughs) It's really good for you.

So, definitely think about
that in terms of how

you manage stress, right.

So, next up we have a
little plug here,

on this particular slide
as review our connections

between bio, psycho,
social, and spiritual.

Or I have a reference here
to massive multi-player

thumb wrestling.

(sings) What!

What is this?

Well it turns out,

massive mutli-player
thumb wrestling,

I love the McGonigals.

Both the McGonigal
sisters are amazing.

And Jane McGonigal,
who is Kelly McGonigal's sister,

Jane McGonigal is
a game designer.

And she didn't actually
design massive

mutli-player thumb wrestling,
but she's the one

who introduced me to it.

And massive mutil-player
thumb wrestling

really is this fantastic thing
where you can actually have

many people thumb wrestling
each other at the same time.

And when they do this,
there's all kinds of

positive endocrine results.

So it really helps you.

Turns out that just
something fun,

right it's playful but
it's touching right,

it's connecting with
other people,

and this actually brings you
to a whole bunch of

different positives.

A bunch of positive emotions.

Right, so there's a very
psychological component to it,

but obviously it's
a social action.

And it really does help to
support our biology too right?

We can talk for hours
about expressive

writing and health.

Expressive writing is one
of the practices that's

been shown to have all
kinds of protective

health benefits for people.

And it's a little-- in some
ways the mechanism of that

still remains
somewhat unknown.

But it is the cases that
expressing ourselves,

right this is a good example
of that psychological

need to express.

Getting that information
kind of out there is

protective of us biologically,
and not just psychologically.

And of course, we can talk
about psychical activity

and it's countless benefits
for many moons.

If you're not already on
board with us in terms of

all of the protective elements
of being somebody

who's psychically active,
then I encourage you to

give it a little try, right.

Even just a little improvement.

Don't think all or nothing.

Don't think about the idea
that you need to become

some kind of crazy
fitness expert or something.

But instead, just try to
up whatever your game is

just a little bit, right?

And then of course,
another example of these

connections are all of
the mind body practices.

So yoga is an example of
a mind body practice.

There are many others.

Visualization, which we
talked about briefly

in our first hour.

Five senses visualizations
are a mind body practice.

Systematic muscle relaxation
is a mind body practice.

There are many that you
are probably familiar

with some of them.

And you probably don't
think to use them on yourself.

(laughs) But if you did,
you would find that

you might get a big self-care
hit off of that experience.

Alright.

Here's a little moment
for us to pause

on a beautiful nature
slide for a second.

I'll give you a minute,
to sort of just

roll around in this.

And really kind of notice
that when opportunities arise,

it doesn't have to be a
all or nothing process

in terms of getting
access to a bit of your

relaxation response.

Dialing back a bit of your
stress build up over time.

That this is something we
can all do everyday

in small ways.

And accessing pictures
of nature is

one of the ways that
we can do this.

So, as we've been talking about
some holistic practices right,

holistic practices take
advantage of

the connections between
these levels of analysis.

We can influence our
minds, our souls,

with our bodies,
and vice vera.

And this is one of the
ways that self-care,

I think of as just having
huge benefits right.

Because you can go ahead
and do self-care in one area

and those benefits will
extend out into

all of these other
levels of analysis.

And it's really the
biopsychosocial model

that helps us to
really see that.

Alright.

Now, so we've got--

let's just skip forward to
our self-care practices, right.

So we've got self-care practices.

These are going to address
those biopsychosocial

and spiritual needs of
the clinician.

It's really about how you
live your life outside

the therapy room, right.

And whether that's influencing
who you can be

inside the therapy room.

And the reason that this
transcends and

goes beyond just a sort
of discussion with humans

about self-care practices,

which would be appropriate
for anyone, honestly.

Anyone can benefit
from self-care.

But it's an especially
important ethical imperative

for those of us
who take care of others

because if we fail to
take care of ourselves,

we will no longer be
available to take care of

the people that
we have committed to

to being available and
being able to take

care of them.

So even though it may
sound a little preachy,

the whole point here of
this being about

the clinician,
about you,

is the fact that you
have a special job and

you have a special need
actually to be able to

take care of yourself,

even more than just all
the regular folks out there.

So know that because
you do that type of work,

and that you are in a
helping profession,

it makes it particularly
important for you to

take care of yourself.

And address all of those
biopsychosocial spiritual

needs that you have.

So, this is about being
your most capable, confident,

competent self as a
helping professional.

It's about how you
manage stress.

It's about whether you
have fufilling relationships.

It's about your
self-regulatory habits.

Right?

Sleeping.
Eating.

Especially substances,
as we know from our work

it's particularly important
to watch for the way

we cope having to do
with substances.

And clinicians are at
high risk of

substance related problems
having to do with coping.

So self-care is one of the
things that can prevent you

from being vulnerable to
that type of problem.

And then of course,
we've talked a lot already

about work life balance
and what the wonderful benefits

are to self-care that way.

Self-care is really what
makes my world possible.

(laughs) It is what makes
my daily life, my job,

something that I can do.

Do well.

Do happily.

And do for a long time.

And that's exactly the way
that I think about the

ethical duty that I have
to be able to give myself

self-care so that I can
provide my clients

with the best care that
I possibly can.

So, self-care.

It does this for us.

It makes it possible
for us to take our

best care of our clients.

It enables our
professionalism.

It maintains our
well-being.

And protects our
motivation to play

the role as helper.

And those particular things,
protecting that

motivation to play the
role as helper,

it's not just a psychological
concept, right?

Motivation.

Is that something where
we would just say

that's psychological?

No!

In fact, one of the issues
with motivation of course

is going to be how it is
that you're feeling

in terms of
your energy level,

in terms of the way
your endocrine system

is functioning.

How regulated are you?

And how well do you
feel like you can

actually rise to the
needs of your day.

Instead of feeling that
you're more depleted

in that way.

Alright, so

we've talked a lot today
in this hour about

the biopsychosocial
model of health.

And we added spiritual
into that as well

because that gives us an
even more holistic view of

the way to think about
a human being.

We've also reminded
ourselves that

we are human beings.

And so it turns out that
actually all of those theories

that we psychologists
have come up with

that are applied to
other people and

are designed to help others,

those can also be
directed at us.

And those can also
be ways that

we can tell ourselves,

(sighs) "I can use these
tools if I've used systematic

"muscles relaxation,
for example to help

"a client with anxiety,
perhaps I might want to use

"that technique also
with myself to help myself

"to feel more relaxed."

There are lots of times
where perhaps

activating the relaxation
response is a very

responsible and other
focused thing

to make yourself do.

So, that's the way
I think about the

biopsychosocial spiritual
theory and the way that

that model applies to
mental health

and to the self-care
of clinicians.

In our next hour of
this hour three of our

four hour series here,

in hour three we're going
to talk about humanism.

What does humanism
have to tell us

about this whole topic?

And I think that this is
particularly exciting

because humanism is
actually an integrated

theory of the how and
why of self-care.

So we got a little bit of
the why from our first hour.

We've got a bunch of
the how that's come out of

this biopsychosocial
spiritual model

in the second hour.

And then in hour third hour
we're really going to

talk about the integrated
model of how

how and why kind of
come together through

Maslow's hierarchy.

Alright, I look forward
to seeing you then.