'Care For The Self? - How Can I Live Caring for Myself in Practice?'

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'Care For The Self? - How Can I Live Caring for Myself in Practice?' Sonia Hutchison

Presented at the Research and Enterprise Conference Cumbria University 3rd July 2015.

http://youtu.be/WaS0n-VLPB8 As a leader of a successful local charity my research has recently been focusing on how to sustain myself as the amount of work becomes greater and more pressured. Informed by Foucault’s ‘The Care of the Self’ I will recognize the contribution he has made to the understanding of the history of self-care, however I will explore the weaknesses of his work in regard to providing a practical framework to implement care of the self. I will also explore the feminist perspectives towards Foucault as The Care of the Self takes a largely male view of self-care. I will use a Living Theory approach in my research. A Living Theory approach enables me to take an ethical responsibility for living my values of love and hope fully. My findings identified the need to develop self-care or I would burnout and no longer be able to benefit those I was seeking to care for. I describe the 6 month career break I negotiated from my day to day work where I travelled to the USA. This paper explores my learning about care of the self from my career break, the influence of my research group and the sustaining nature of regular Skype and email support as well as the research group’s learning about self-care. This paper will be of interest to many in the health and social care professions and those with a leadership role. It is particularly pertinent in this time of austerity where there are increasing pressures on personnel to be seen to do more with less time and resources, which can lead to ‘burnout’. Introduction I will use a self-study of my near burnout as a leader of a successful charity, which has more than doubled in every way in the last five years, and my use of a career break to practice caring for myself. I will explore the use of Foucault’s paper in creating knowledge that is useful for professionals facing burnout. Through my reading of Foucault’s publication, the third book in the trilogy The History of Sexuality; Care of the Self (1986), I will critically engage with the literature in the light of the increasing problem of burnout for professionals in a time when austerity is demanding more for less. I will contrast this with the knowledge I have generated through my lived experience. Living Theory of Care for the Self Living Theory is a practice based methodology enabling practitioners to research their own practice. This has influenced my approach to self-care to diverge from Foucault’s abstract conceptualisations of ‘care’ and the ‘self’ where these are researched from a historical perspective. Instead I have designed a self-study which places myself at the centre of the research. Not as a narcissistic endeavor (Coffey, 1999) but as research where I take ethical responsibility to bring hope and flourishing to humanity whilst caring for myself. Using my lived experience of attempting to care for myself and through the

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experiences of members of research groups I am part of, I explore an answer to the question - how can I live caring for myself in practice? When the term sustainability is used in research it often focuses on environmental or economic forms of sustainability (Carroll and Buchholtz, 2015) ignoring the need for practitioners to maintain their own well-being to prevent burnout and sustain their own energy to continue to support those they seek to benefit. I am a Chief Executive developing a highly successful carers’ charity. I have evidence of my success based on measurable change such as socio-economic growth. Since I started the charity has more than doubled the size in all aspects including beneficiaries, income and staff. Whilst I am proud of these achievements in line with my Living Theory approach the criteria I judge my success by is based on my values. Therefore, the standards of judgement that I measure my success are my values of love, hope, participation and justice in practice and whether I live these fully in my practice. I have explored how successful I have been through my research (Hutchison, 2011, 2013, 2014, 2015). However, after four years the organisation experienced some human resources difficulties. As a new area for me I found the time consuming process led me to become a ‘living contradiction; (Whitehead, 2008) where I found my values were negated in practice as I found myself working in a legalistic, secretive and harmful system. This experience led to a struggle to maintain my energy for the role, an inability to balance my role at work with other interests and commitments and feeling exhausted:

‘Burnout is a syndrome of emotional exhaustion and cynicism that occurs frequently among individuals who do ‘people-work’ of some kind. A key aspect of the burnout syndrome is increased feelings of emotional exhaustion’ (p.99, Maslach and Jackson, 1981).

I could feel I was heading towards burnout and could see many colleagues internally and externally heading in the same direction. I lacked the knowledge I needed to prevent myself burning out and could only think that leaving would solve the problem. I felt this solution was not satisfactory as I neither knew where I wanted to work next nor no longer wanted to work for the charity which I was so proud of the development I had led and wanted to continue to lead. I decided to pursue a six month career break where I would have the time and space to recover, physically, mentally and spiritually and could make an informed decision about my future. Negotiating My Career Break I had recently visited California and had fallen in love with San Francisco and Lake Tahoe which made deciding what to do in my six months an easy decision and I am studying for a PhD which gave me an additional purpose to my sabbatical. However, in a medium sized charity where no one had ever taken a sabbatical, I had to begin by convincing the trustees that the risk of letting their CEO leave for 6 months with no guarantee of returning was a risk worth taking. I also needed to be sure that the Senior

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Management Team in particular would not be adversely affected by my absence and that the change in roles would strengthen the charity rather that weaken it. This led to a number of open and honest conversations with the trustees and the Deputy Chief Executive who would act up in my absence. I put together a paper for the trustees to argue my case focusing on the risks not just for my role but also for my Deputy. My comment in my appraisal summed up my feelings at the time:

‘I would like the trustees to consider allowing me to take an unpaid sabbatical in October for 6 months and moving my Deputy to acting CEO and filling the operational manager role whilst I am away. I have been considering resigning in October but after discussing in supervisions I feel this would be a good compromise and gives the organization more stability and my Deputy career progression which he is seeking. It enables me to come back if things don’t work out in the States and if I didn’t come back it gives everyone a chance to plan for a future without me in it. I have discussed this with my Deputy and he is supportive.’ 10/1/14

This shows how close I was to leaving my post and as I wrote in my Reflective diary:

‘I have also been thinking a lot about burnout as one of the reasons I feel I need this sabbatical so much as it feels like the best way to avoid burning out. I may not come back but I think I am more likely to come back and be able to do my job and have a work life balance if I do have this sabbatical.’ 2/8/14

I was live to the risks of leaving and worked with my Deputy before leaving to look at how gaps could be filled in my absence. An area where I am strong in is the fundraising for the organization and was an area my Deputy felt concerned about in my absence. He was reluctant to employ someone new to the organization in case they needed a lot of supervision or failed to raise any money. My partner suggested I could do bid writing in the USA which resolved my Deputy’s concerns and my need for some income. This again needed a lot of negotiating and in the end my Deputy presented a paper to the trustees and gained their approval. Trustees had doubts about this idea but as I shall explore this ended up being a positive way to remain in touch without feeling I was still ‘at work’. I heard staff talking about their concerns as would be expected, however, I also received a lot of positivity with emails saying:

‘I really hope you enjoy your sabbatical – a good opportunity.’ ‘Meant to say congrats on getting your sabbatical I bet it's going to be fab and you deserve it after the tough last few years.’ ‘I do want to hear all about your exciting plans for your trip I think it’s a great opportunity for you and am very pleased the Trustees have let it happen.’

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I found these responses affirming whilst being aware that other staff had more concerns about how the organization would continue to be able to function fully with one less Senior Manager in post over the six months. The trustees had been keen for a time of consolidation after so many years of rapid change. I had been honest and explained that I don’t know how to lead on consolidation as my approach is to continually improve my practice which by nature is a process of continual change. The six months provided an opportunity for consolidation as both a pragmatic approach to the reduced staffing level and to the trustee’s requests. In all staff communications this was the key message along with a plea for staff to support the Senior Managers in my absence. My final day was the AGM and provided a public opportunity to hand over the baton to my Deputy and to say goodbye to people both internally and externally before I left.

Video 1 David Trumper Deputy Chief Executive taking on the Acting Chief Executive

Role at the AGM 2014

I feel that this video shows that I was leaving the charity in safe hands with a person with great integrity, sense of humour and ability and that we have great mutual respect and trust in each other. California Picture 1: Montage of my time in California

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My time in California gave me time to put into practice self-care, Firstly I felt having a place that was comfortable and we could have friends and family to stay was important, we quickly found a place in Lake Tahoe, deciding that the rents were too high in San Francisco. I then set up time every day to have exercise outdoors, initially hiking and Freebording, a niche hobby I have, and as the ski resorts opened included skiing every day my Season passes would allow me. I made time to cook healthy food with lots of salads, vegetables and fish. I made time to spend with friends and family both in the USA and in the UK. I returned to my Tai Chi practice and later learnt some Yoga practice and meditation to compliment this. I spent a lot of time with my partner and supporting his Care of the Self. I made sure the work I had to do fitted around these and prioritized my Care of the Self rather that putting the work first. This did not mean I did not work hard, when I was working I worked very hard and wrote over 200 bids, spent time developing my PHD work and working for two other not for profit organisations. However, part of my learning was how to achieve all of these tasks whilst achieving self-care. Certainly living in the mountains of California where the ski resorts were only 10 minutes away and the surrounding countryside beckoned to be walked or ridden helped to keep my focus on my self-care. Getting up and skiing every morning never felt like a chore and I never once took for granted the view of the Lake from the top of the mountain. I appreciated every moment of my sabbatical, however, I decided early on that I was not going to actively seek remaining in the USA after the six months and that I would return. Part of my self-care was to remain boundaried about the time I had for my sabbatical. I planned to finish all my work two weeks before returning back to the UK so I could have a true holiday and return refreshed and enjoy the time before returning. Friends came for these final two weeks which helped to buffer the difficulty leaving our Tahoe home. We spent a week in San Francisco seeing friends and enjoying a Freebording event riding in San Francisco with friends we had made. We then broke the journey up visiting Niagra Falls and Dublin on the way home. All these things helped to make returning to the UK easier along with family picking us up and cooking for us when we arrived back.

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Video 2: Friends from the Internet a short edit a friend made of us Freebording

I read Foucault’s The Care of the Self whilst I was in California which left me frustrated at the lack of practical guidance on the subject. I felt I needed to experientially practice self-care in order to gain the knowledge to care for myself, I did not find I gained this from reading Foucault.

Foucault, The Care of the Self Foucault is an influential thinker of the modern era, he:

‘was a French philosopher or more specifically a historian of systems of thought, a self-made title created when he was promoted to a new professorship at the prestigious Collège de France in 1970. Foucault is generally accepted as having been the most influential social theorist of the second half of the twentieth century.’ http://www.egs.edu/library/michel-foucault/biography/

Foucault’s The Care of the Self (1986) is the third part of the trilogy The History of Sexuality. The book explores the history of sex and sexuality providing abstract generalisations of care of the self. Foucault focuses on historical examples, of pragmatic and largely morality free, ancient Greco-Roman methods of care for the self contrasted with the morality driven Care of the Self promoted by Christianity.

Stephanie Batter’s (2011) essay provides what I found to be a useful translation to modern day from Foucault’s complex review of the ancient Greco-Romans view of care of the self and yet at the end she comments that:

‘Foucault’s frequent return to the ancient schools of thought made it difficult for me to apply these concepts to my own present day’ (p. 19).

I share this view and found that as I read Foucault The Care of the Self I found myself struggling to find the text able to provide me with any practical guidance around self-care in the pressurized health and social care environment in which I work. However,

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Stephanie Batters attempts have been of more use to me practically as she distills Foucault’s work as:

‘Care of the self constitutes lifelong work on one’s body, mind, and soul, in order to better relate to other people and live an ethically-driven life.’ (p. 2).

I find myself able to relate to Stephanie’s summary of care of the self in a way I can’t find in Foucault’s text. She goes on to say:

‘care of the self first and foremost constitutes creation and governmentation of self. It requires a continuous practice of introspection that simultaneously allows for a realistic sense of one’s own surroundings.’ (p. 3)

Concluding that:

‘social and self understanding should always be fluid, evolving, and subject to change at any given moment.’ (p.12).

Stephanie’s Batters useful distillation of Foucault’s text enables me to identify links with concepts of reflection and reflexivity which are current methods to improve practice and continuing professional development. Stephanie Batters highlights:

‘Meditation and journal-writing have shown in countless settings to be helpful in times of stress and trauma, even thousands of years after the practice first evolved. While these practices may be ancient, many modern folk would argue it is certainly not irrelevant. (p.18)

I find myself finding Stephanie Batters essay more engaging and useful for achieving self-care in practice than Foucault’s writing. Care of the Self is written from a largely male perspective, partly perhaps due to the author being male, and partly due to the review of historical documents. This problematizes the use of the text for me as a woman. I find the text loses relevance to me when ‘women are noted as an aside’ (Foucault, 1986, pg 7) in many of the texts Foucault reviews:

‘To date, feminists are torn between on the one hand, disliking Foucault for neglecting to include women within the frames of his theories and on the other hand, recognizing his value as a rhetorician and the potential of his theories in conjunction with feminist studies.’ (Marome (2005:p. 118)

Whilst McLaren (2002) acknowledges the various feminist criticisms of Foucault she:

‘concludes by showing that his idea of practices of the self can be applied to contemporary feminist approaches’ (p. 3).

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However, Deveaux, (1994) argues that:

‘a Foucauldian conceptualization of the subject to erase women's specific experiences’ (p. 224).

As a women and liberal feminist who believes that ‘men and women … have the same rational capacities .. men and women should be treated equally’ (McLaren, 2002, pg 6), I would find the text more useful if the female perspective were acknowledged. Finally I would argue that Foucault’s language and interest in the sexual history of the ancient Greeks and Romans makes the text difficult to understand and to relate to the working environment in the 21st Century. Longson (2010) states:

‘Foucault’s writings have been subject to heavy criticism for his confusing language and winding metaphors. Philp described Foucault not only as difficult to understand, ‘but deliberately so’. Many have therefore baulked at his ideas, intimidated by language not often used in historical study.’ (p. 2).

I would argue that although Foucault was wanting to ‘change perceptions’ (Longson, 2010 pg2) due to his use of language and examples that lack resonance with practitioners his text, without interpretation, lacks practical value in today’s workplaces. Leaving Foucault’s ideas to continue to have impact and relevance to academia whilst a need arises for new forms of knowledge to be created on Care of the Self which are accessible and give practical help to practitioners struggling to achieve this in day to day life. However, Silva et.al (2009) did find Foucault more useful as they were interested in locating caring for yourself within a paradigm which they define as

‘ways of thinking, rules and values shared by a certain scientific community’ (p.694)

Their premise is that self-care and care of the self are not just semantic differences but that they represent different paradigms. Their view is that knowing and understanding which paradigm self-care and care of the self fit within will improve usage. They summarise that self-care is based on a paradigm of a totality where a person is made up of biological, psychological, spiritual and social which enables them to adapt to their environment. Alternatively Foucault’s notion of care of the self is based on the paradigm of simultaneity which values the subjectivity and individuality of people. For me both of these perspectives are important. However, these findings still lack a practical guide to self-care or care of the self and return me to my own self-study to find a way to live caring for myself in practice. Returning to the UK I have returned back as the Chief Executive with a different perspective. I had always thought my role was to model hard work which would inspire staff to also work hard. I

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have now realized the real challenge is to be a role model for self-care and show that if I look after myself I can achieve more when I am working hard and inspire staff to prioritise their own self-care. I am trying to keep up the habits I developed in the USA. I am taking public transport several times a week to work and walking for five miles on those days to enable me to have exercise outdoors, I have begun to practice riding the route to work with a view to riding to work once a week. I am continuing to cook and eat food with lots of vegetables and salad. I have prioritized catching up with friends and family since I have returned and have lots of social activities booked into my diary. I am trying to go out of the office to eat lunch and phoning a friend or my partner to have a break from the office and work. I am wearing bright clothes to use my wardrobe to keep me feeling bright and happy and have given lots of my dull clothes to charity. At a strategic level I am leading the organization from a position of valuing self-care that is not negated through hard work but rather sustains the ability to work hard. I am being overt in the change in my perception that has taken place as a result of my sabbatical. This is both by reporting my learning to trustees and talking about my learning with staff and colleagues. Through sharing my learning in this way I am making myself accountable to continue living a self-care model. By making myself accountable I am able to reflect whether I am living self-care in practice or being a living contradiction. I am also providing permission to change the culture operationally and for policies and new ways of working to be developed to encourage self-care. In my absence a number of steps had been made to move the organization in this direction, as the permission being given for me to go on sabbatical challenged the organization that all staff needed to have similar possibilities. In that sense the very act of me negotiating and taking a sabbatical has changed the organisations approach to self-care. In addition to these gains my sabbatical was also successful in my time fundraising and since returning I have gained well over £100,000 from the funding bids I submitted. I feel this is important to add as this also shows the trustees decision to allow me to fundraise whilst I was on sabbatical also benefitted the organization. Others Experiences I have found having a weekly Skype with the research group I am a member of has been a method of self-care in and of itself, as it has sustained my research and my love and hope in what I am doing. The research group also provides the function of a validation group that responds to my writings by adapting Habermas’ criteria (1973) in relation to enhancing its comprehensibility, evidence, sociohistorical and sociocultural understandings and authenticity. In the Skype sessions we have discussed self-care and other research group members have also shared stories of when they have experienced burnout or where they have been in situations where their well-being has been negated by the organization they were working for. One colleague summarized this in an email:

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‘In a so called caring profession the management structure seems to ignore the needs of its work force. It seems to come down to limited resources. In the long term it leads to more staff sickness, staff burnout and a lack of staff retention. It also affects staff morale and productivity.’

I found this reflection useful, not least because I can see that I could be accused of fitting into this description at times, not with the intention of causing staff sickness, staff burnout or causing staff to leave and yet occasionally leading to those consequences. Not just of other staff but nearly causing my own burnout. From my own reflections I recognize this is because I was seeing my role being to model hard work and to enforce that others need to work hard even if it was at the high cost of people’s health and energy levels. I was able to justify this stance because we are an organization that put carers at the centre of everything we do, not ourselves. I have realized through my reflections that this is actually a contradiction as one of our key messages is for carers to look after themselves or they will not be able to look after the person they are caring for, they will burnout. However, I was not living this in practice at work, nor encouraging staff to do so. Another example a research group colleague gave was their ways of living self-care even in the most difficult of circumstances:

‘Just to give you an example after spending some years in Afghanistan with no possibility to go for a walk, to a gym, to yoga, for a hike and after the terrorist attack to the 5 stars hotel where I used to swim I had to quit swimming too ….well I really enjoyed giving myself a manicure and I was not ashamed of having perfect finger nails at all!! These kind of small ‘treats’ make me feel better and still feminine, especially when I look like a bear after months spent in a rural area. So now I found my balance and I know how to treat myself and at the same time enjoy both my sometimes tough job and my life. And above all I understood that I don’t have to torture myself in order to be a good international development professional.’

There is certainly a danger that I have observed of getting into a competition about who works hardest. I have been involved in a number of conversations where it feels like a competition of who has worked hardest where everyone lists how late into the night they worked, how early they started work, how they worked at the weekend and that they can’t remember the last time they had lunch away from their desk. Whilst often these conversations are to share the pain of working hard, I am now keen to be able to say actually I am eating my lunch away from the desk, that I’m leaving on time and having a walk before I get home and not getting on with work at the weekends but doing things I love doing that make me feel healthy with people I love spending time with. I want to be able to say that this helps me to get more done in the time I have. I am certainly doing better and can say those things most of the time and that I am still getting the most

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important things done. However, I need to keep practicing as it is easy to fall back into bad habits. Findings My own living journey of self-care has provided me with a start to developing a practical knowledge of how to approach work in a way that prevents burnout and develops a culture of wellbeing in the charity I lead. I did not find reading The Care of the Self helped me to this knowledge as I found the historical review of a male dominated world of the ancient Greeks and Romans did not resonate with me as a female living in the modern world. Technological advances, the current economic pressures brought about from a policy of austerity and the demands from funders make Foucault’s review lack relevance. I have instead used a Living Theory approach to identify what I need to manage my own self-care in the socio-economic climate I find myself in. My findings have identified that I need to spend regular time each week outdoors, exercising. I need to find time to spend with friends and family. I need to give myself time to reflect and process what I am doing and that a reflective diary and researching my own practice helps me to achieve this. I need to make time for my studies and other work to prevent myself becoming stressed. These are not unique findings and are common suggestions in self-help literature, however, my own journey has been important as it is in the experience of getting to near burnout and recovering that I have been able to learn this. I would advocate organisations to support their staff to take breaks to gain this learning for themselves, creating environments where staff are empowered to take time away and develop the self-care that works for them. My own self-study has given me evidence, that rather than being a risk giving staff opportunities to develop their well-being outside of the work environment, it actually strengthens rather than weakens the sustainability of the organization. My experience has shown me that by leading from the top gives permission to change the culture. The additional benefits are the opportunities for other members of staff to cover the role providing opportunities to act up and gain new skills and to provide opportunities for succession planning. In my case I think my Deputy is far more competent and confident and the Senior Management Team has been up skilled as a whole as they covered my role in my absence. Other staff members are becoming more creative and taking longer leave, developing their own well-being and providing opportunities to ensure other staff learn how to cover their role in their absence. There is further opportunities for learning where I could review staff appraisals and supervisions to see if those staff that are being more creative in their leave are managing their well-being better. Also as an organization we are focusing on developing more in house support to help staff develop their well-being which provides further opportunities to research whether these actions are improving staff well-being. Finally my ongoing self-study will identify whether my sabbatical created a lasting change or whether I fall back into prioritizing hard work over self-care.

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My standards of judgement for my practice and my research are living values that I hold. Two of the values I hold are love and hope. In ‘people’ professions we often fall into the trap of loving and hoping for others, however without loving ourselves and creating our own possibilities we can burnout or become cynical and no longer be able to provide love and hope to others. Ubuntu is an African philosophy meaning I am because you are. This certainly ensures we look after the other. However, increasingly I am understanding that ‘we are because I am’ (Huxtable and Whitehead, 2015) and that if I do not look after myself I am unable to look after the other. Conclusion The current policy of austerity has led to the helping professions having to do more with less. There is more demand and less resources to provide the help people so desperately need. Self-care can seem like an abstract concept which is how I found reading Foucault’s Care of the Self, rather than feeling relevant and practical, I found his work patriarchal, hard to understand and with little or no resonance with my need to care for myself to prevent burn out. Instead using a Living Theory approach I researched my own experience of near burnout to finding a solution through a 6 month sabbatical. I am now trying to maintain the principles of self-care which I identified in California back in my role as CEO. Through the action of taking a sabbatical the culture has started to change and now in my return I am seeking to continue this momentum.

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