#useofself

In hopes of chronicalling my development as a social worker, returning to my roots is the best start. At my core, I am still a 14-year-old girl in high school with a few friends and too much free time to spend/waste watching shows and being online. Now, that girl has homework.

For thoughtful practice, I need to figure out how exactly I want to practice. This will require me to pie-chart my brain and my way of thinking into quads:

Knowledge. Know your theories and know them well. Strengths-based, trauma-informed, systems, etc. But don't just know them, learn how to see them. Understand them. Flex them like a muscle.

Skills. What do I have to offer, and what do they look like at a micro level? Is simply being able to talk to someone really a skill?

Ethics and values. Personal and professional.

Use of self. Who am I, and how do I interact with my work? How do I show up? Am I emotionally intelligent? Do I know myself? Does anyone really know themselves? Time to crack the code.

Disclaimer: This is a very self-indulgent example on my part. As one of my favourite movies of all time, I take any opportunity to talk about LMS. And, as it happens, it's a great example of how different systems look within a family unit and how other people may respond to traumatic experiences. Multiple generations living within the same household, suicide, marital conflict, a teenager going through a bit of an identity crisis, and so much more.

From a family systems perspective, the disruption of the nuclear family is at play. At a point in time, the family unit was composed of the mother (Sheryl), father (Richard), son (Dwayne) and daughter (Olive). They played their own role in slightly disrupted ways. We find out that Sheryl is the primary income earner, as Richard pursues a... unique career as a motivational speaker. Dwayne and Olive have a considerable age gap, possibly implying she was not planned. Dwayne is at the stage of identity formation, taking extreme steps to show his dedication to his future by taking a vow of silence until he reaches his goal of joining the flight academy.

Off screen, their family system becomes disrupted when Richard's father, Edwin, moves in with them. In some cultures, it is expected that older parents move in with their children; however, the audience can easily tell this is not the case. It creates a "sandwich generation" relationship, as Richard now has to provide for his own family as well as his father. This becomes a source of embarrassment, as Richard is barely providing for his family, if not for his wife.

The catalyst for further disruption occurs at the beginning of the movie, where we see Sheryl pick up with brother, Frank, from the hospital. He has recently attempted suicide and requires 24/7 monitoring, and Sheryl invited him to live with her family.

This movie offers many thought experiments throughout its runtime, as we see characters navigate their own disruptions as well as their interactions with each other. For example, we can recognize Richard's complete lack in TIC as he skirts around the topic of Frank's suicide attempt, going as far as calling him a loser when Olive asks why he did it. Sheryl and Richard would benefit from a type of couple's support, as we see them having a blow-out fight over income and impending divorce. Edwin is misusing heroin, and Dwayne has a complete identity crisis when he learns he is colour blind.

I genuinely don't know why this has always been a harder sphere for me to delve into! Don't I know what my values are? What ethical dilemmas do I find more or less difficult? That's a good place to start: familiar ethical dilemmas.

It feels important to listen to this while trying to make your ethical decision.

The classic is the trolley experiment. It is so well known at this point that Mr. Beast included it in his Amazon show, "The Beast Games." One track has one of the most important people in your life (partner, friend, child), and the other has 5 strangers. Do you move the train, intentionally saving your person and killing the strangers, or let the train continue on the track, as objectively 5 lives are worth more than 1. I have decided to leave my answer not attached to my digital footprint.

In complete seriousness, the field of social work is composed of ethical dilemmas, some big, some small. It contributes to burnout or compassion fatigue, having to make all these micro decisions that may determine whether someone is housed tonight or not, or who out of a group of 20 will receive a spot in treatment.

When I returned to school, a new concept had been introduced: self-care. From context clues, I could guess what this referred to: taking care of ourselves. It was in the syllabus, on slides, and whole classes were dedicated to teaching self-care. Where was this when I was wrapping up my first undergrad, sleeping at 4 a.m., and eating nachos for dinner? I guess I can say that was its own form of "self-care."

Now, two years back in the game, I can speak on the importance of self-care and why it shouldn't be demoted to a buzzword bandaid. Especially within social work, taking meaningful time to check in with yourself is important for practice. The field requires professionals to place themselves in emotionally elevated environments as they walk alongside their clients. Burnout and compassion fatigue are potential symptoms and a reason why self-care needs to be part of practice.

It is also important to note to be critical of how self-care is taught. Depending on the setting, self-care can be put into a neoliberal context, framing it as a way to ensure you will always be just at capacity to be professionally productive. However, self-care is more than making sure you can come into work tomorrow. Holistic practice encourages us to consider our spiritual health, which can go beyond religious ties.

Definitions:

Burnout (n): being emotionally, physically, spiritually, and/or mentally exhausted as a result of being exposed to prolonged stress.

Compassion fatigue (n): being exhausted as a result of being constantly around others in heightened emotional states, traumatic environments, and/or stressful situations.

For me, self-care looks like a whole bunch of things! A non-expansive list...

RNGing a movie from my watch list (or putting on an old favourite)

Going for a walk the length of my current favourite album

Seeing a movie/calling/going out for dinner with a friend/friends

Knitting with my mom

A long shower

Spending extra time on my hair and/or eye makeup in the morning

...and nachos for dinner. Because some things never change.

Occupational Therapy is known to be the most diverse medical profession as it uses a holistic approach during assessments and interventions.  There are different frames of reference, models, and techniques used in occupational therapy to analyze and shape interventions. There is also one technique known as “therapeutic use of self”.  According to Finlay, (2022), the therapeutic use of self is the self-aware intertwining of both our professional self, the one that uses knowledge, skills, and techniques) and our personal self (which arises from our history, beliefs/values, personality, and embodied lived experience) https://www.lindafinlay.co.uk/therapeutic-use-of-self/. This is known to be a tool where one (therapist) uses themselves in a way that they become an effective tool in the evaluation and intervention process.

According to Cam (2022), therapeutic use of self is when practitioners leverage their own knowledge, personality, thoughts, feelings, or even their physical body to benefit their patients. During assessments, it can be used to build rapport with the client or social support by empathizing with the client, encouraging and giving them hope. In short, we use ourselves to advocate for patients to gain access to resources, collaborate with the client (autonomy), encourage the client by positive re-enforcement, educate the client about important issues to be considered and help problem-solve which will enable our clients to reach their ultimate occupational goals. For more details visit Cam’s YouTube page at https://www.youtube.com/watch?v=uNZDTPiY140.

Therapeutic use of self to me, means understanding my patients and treating them with an understanding that they are real human beings, not robots to be used for academic purposes. Even thou I have little patient which I am willing to work on, relating to my patients in terms of how they may be feeling is important for me. Having the role of being their therapist doesn’t make me superior to them hence “we might be in different positions, but we are all living in the same world”.  It is all about being a human being in relation to another human being. It's less about applying therapy techniques and more about finding a way to be with our clients, in patience, curiosity, compassion, caring, and challenge, while we go exploring together how we can make life meaningful again, Finlay (2022).

In my journey of being an OT, I have used my interests and lived experience during therapy, especially during assessments. In 2022 on my first Psycho-social block I had a patient who was not willing to engage in therapy. But I started sharing my love for football and how I have sustained injuries whilst playing. He then started mentioning his perspective on football which then led to having more conversations as this allowed him to warm up to the student therapist, he was seeing for the first time, and already asking questions. Therefore I used myself to elicit better outcomes during assessments (https://lifelonglearningwithot.wordpress.com/2016/04/20/therapeutic-use-of-self/#:~:text=Therapeutic%20use%20of%20self%20is,information%20you%20choose%20to%20share%E2%80%A6). We even utilize this technique unconsciously.

For intervention, this reminds me of the young male adult who was involved in a car accident rendering him T8/T9 dislocation. He had fluctuation of moods due to the sudden permanent changes in his life. Having to adapt the sessions, empathize with him, and physically do passive mobilization, and then educate him to minimize contractures was also a therapeutic use of self. This technique can also apply to physical aspects of life not only psychosocial such as sharing common depressing stories to help others pull out of their depression states or making them see that other people also go through what they are going through or relate.

This also reminds me that how we treat our patients really has an impact on when and how other clients can start seeking intervention. If the word of mouth is that Ots treat their patients like trash. No one even in their sickness would like to be treated as such. So, it is important for us to use ourselves in a good way. In closing this is advocating us to always practise the Golden Rule!

For more information on the therapeutic use of self, you can also visit the OT Practise framework online: American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), Article 7412410010. https://doi.org/10.5014/ajot.2020.74S...

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Today, in my “Use of Self” course I got to hear the life stories, or life landscapes of my 19 classmates and my 2 professors and I am really glad I have the life I do. This had just served as a testament to me, more than anything, that our loving Heavenly Father gives us exactly what we can handle. After hearing some of their stories, I don’t know how I would have faired in their situations. Because I am a very different person than them, and have my own personality oddities, I may not have come out as well as they seem to be. I have never had to deal with a politically brainwashed family. I have never had to deal with being sexually abused. I have never had to deal with being raised by a grandparent because my parents abandoned me. It made me feel guilty for thinking that my life is hard. EVER. Because in reality it’s not that bad, but then when those same people whose stories I could never have survived heard my story they felt the same way. Clearly our Father knows exactly what we can handle and what we can’t. The fact that we are all here means that we COULD handle it, and that we did. It may have changed us. It may have shook us. It may have left us gasping for breath, thankful for the ride. But we did it.

And we CAN do it. And we will HAVE to do more.