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ss triple helix - winter 2013,  Caring for ourselves

Caring for ourselves

KEY POINTS
  • Doctors (with other caring professions) must respond to high demands because we are in direct contact with human pain and needs.
  • Prevention is better than cure. We need to know how to identify warning signs of burnout: irritability, nervousness, fatigue and harsh words.
  • Christians need a better theology of work and of what success looks like.

Pablo Martinez warns how easy it is to neglect our own personal well-being.

They made me take care of their vineyards, but my own vineyard I neglected.' (1)

Caring for our own 'garden' (person) is not only a right. It is a duty. It is part of good stewardship. Some people never think of others; they are the paradigm of selfishness. But others never think of themselves; they become the paradigm of stressed and burnt out people.

Far from being a sign of a more 'spiritual' attitude, this can be a serious mistake and even a sin. Robert Murray M'Cheyne, a young Scottish minister, lay dying at the age of 29. He turned to a friend and said:
'God gave me a message to deliver and a horse to ride. Alas I have killed the horse and now I cannot deliver the message'. (2)

The empty pool syndrome

In all professions you have to give something of yourself. A certain amount of inner energy is always required to perform our work adequately. In the caring professions (including pastors, counsellors, social workers) this self-giving is increased because you are in direct contact with human pain and needs. Jesus was aware of this reality: '...power has gone out of me'. (3)

We can compare our life to a swimming pool and our energy to water. Two streams of water need to occur at the same time: output, water coming out (our inner energy: emotional, spiritual) but also input, the water coming in, which is our personal renewal and refreshment. Whenever there is more output than input, the pool gets empty little by little, leading finally to burn out.

In nature we see the same fact: the principle of the two movements. Everything in nature has rhythms which are complementary: winter and summer, night and day. One must follow the other. Our hearts are another excellent example: contraction - systole - follows expansion - diastole. The two movements are successive and complementary: the heart receives blood; then it is ready to distribute it. Unfortunately many people have not learnt to be in diastole; their life is a permanent systole. Blaise Pascal is credited as saying, 'All of man's misfortune comes from one thing, which is not knowing how to sit quietly in a room.'

Knowing when the pool is getting empty

Prevention is better than cure. We should identify the warning symptoms before the pool is empty (burn out): irritability, nervousness, fatigue, harsh words, especially when you are at home and you relax.

Another sign is inability to anticipate or experience pleasure. You cannot enjoy small things in life; work becomes burdening and boring; lack of excitement or enthusiasm about new projects or goals.

Yet another is the 'Ecclesiastes syndrome': a sense of emptiness that nothing seems worth doing. Then another sign is onset of bitterness: being 'too disappointed', complaining about others so the causes (responsibility) seem to be outside, not within me. We can find ourselves becoming hypercritical, even cynical. Alongside all these often come bodily symptoms such as insomnia, somatic anxiety and hypertension.

Attitudes that spoil your garden

One powerful spoiler is perfectionism, when we lose the struggle against the 'inner policeman'. There is a difference between neurotic (compulsive) perfectionism and the search for excellence. The latter is related to spiritual maturity and seeks to please God. The former arises from insecurity and very much needs the approval of others. In a fallen world we have to find a healthy balance between idealism and realism. There is a need to accept our limitations and control our fantasies of omnipotence.

Another spoiler is not knowing when 'enough is enough'. Over-activism (dispersion) - occurs through being involved in too many front lines and this jeopardises both excellence and health. The problem may be due to:
Lack of clear objectives and goals.
We need a 'road map' for the race of life. The importance and need to build up personal support and accountability relationships (mentors, advisers). Meet with them once or twice a year.
Difficulty about saying 'no'.
When I say 'no' I am likely to feel guilty. Learning to refuse is essential to health. The word 'yes' is very powerful, but the word 'no' is very healthy.

Hans Bürki, a former IFES Associate General Secretary often said: 'Reduce, renounce, simplify.' The writer of Ecclesiastes offers this realistic advice: 'Better one handful with tranquillity than two handfuls with toil'. (4) We may be able to do many things, but very few are really important.

Yet another spoiler is self-ambition, being too worried about 'my name'. We see this in the story of the Tower of Babel where motivated by what is known as the 'Babel Syndrome' people build a huge tower, 'so that we may make a name for ourselves.' (5)

We need to review:
Our theology of work.
Work is not an end in itself; it is an instrument, not for self-fulfilment but to accomplish God's purpose for my life. (6) Some people do not work for living, but rather live for working. This is a perversion of the biblical order.
Our theology of success.
There is enormous pressure to be the best. The cost and pathology of being 'a number one' takes its toll. We can become driven, like Björn Borg, the tennis champion, who said, 'I just hated to lose.' He admitted he hated losing even at practice.

But what is a winner? There is a huge difference between how our society sees success and the biblical idea. Success in the Bible does not depend primarily on results, but on the attitudes with which we perform our work (faithfulness, perseverance, obedience, love etc.).

Hurry, too much pressure and haste, is another spoiler. We know working a lot is tiring; working hastily is draining. We never give the impression that we care when we are in a hurry. Carl Jung is said to have put it this way: 'Hurry is not of the devil; it is the devil.'

Tending the garden: caring for ourselves

'…take care of yourself and of the doctrine…' (7) The young Timothy received this advice from Paul. Notice the order: first the person has to be right; and then the work. In this case the teaching. If the person is not all right, the quality of the work will be affected.

So, how should we then live? The origin of stress may sometimes lie outside ourselves, but its treatment is always inside us. Stress is not a disease itself, it is the symptom of a deeper problem. If you do not want to neglect your garden, three tasks are necessary:
Pruning: learning to renounce. Remember Jesus' admonition of Martha? 'Martha, Martha, you are worried and upset about many things...Mary has chosen what is better.' (8) Every gardener has to prune the trees so that they may grow properly and bear more fruit. Pruning in your life may imply renouncing. It may just be small things; or perhaps big areas. Choosing is a constant and necessary exercise in life. Choosing between the good and the best may be a very difficult task, but necessary for you to 'survive'.
Watering: learning personal renewal. This is the key to keep the plants fresh and alive, otherwise they wilt. Our input comes essentially from our relationships. Four possible springs of fresh water: The relationship with God. The vital value of prayer and personal meditation on Scripture. The example of Jesus. The relationship with our family: spouse, children, parents. God uses family members to provide support and renewal. The example of Moses. The relationship with special friends. Paul's example is worth exploring. The relationship with books: reading is basic in personal renewal. Some books become like living friends. Karl Menninger, author of Man Against Himself, extols the value of 'bibliotherapy'.
Waiting: patience is a great virtue. 'Be patient…until the Lord's coming. See how the farmer waits for the land to yield its valuable crop and how patient he is for the autumn and spring rains.' (9)

In the Bible three concepts go together. They are like the legs of a tripod: Peace (shalom), health and truth. Ultimately, health is inseparable from God's peace and both of them are inseparable from God's truth. This is the simple yet profound secret of personal renewal, because real self-care can never be fully achieved by your own effort, apart from God.

'Nevertheless I will bring health and healing. ...I will heal my people and will let them enjoy abundant peace and truth…'(10)

Pablo Martinez is a consultant psychiatrist, Bible expositor and author on the interface of Christianity and mental health. He lives in Spain.
This article is based on an address at the CMF Oxford Day Conference, November 2012.

An Italian translation of this article is available on the AMICO website (CMF Italy)

References
  1. Song of Songs 1:6
  2. Sanders JO. Spiritual Leadership. Chicago, Moody Press, 1967:147
  3. Luke 8:46
  4. Ecclesiastes 4:6
  5. Genesis 11:4
  6. Colossians 3:23.24
  7. 1 Timothy 4:16
  8. Luke 10:38-42
  9. James 5:7
  10. Jeremiah 33:6
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