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Is Self-Care Possible for Everyone?

2020 was a difficult year for all of us. But now it is behind us, many people will be looking ahead to a more positive 2021. There has been a large focus on the promotion of ‘self-care’ in the past year on social media. This has hopefully encouraged many people to learn to look after themselves better. But, for some people with PTSD, self-care isn’t something that is possible. Because if you can’t show yourself self-compassion, then how can you exercise and feel deserving of ‘self-care’?

In this blog, I will discuss how self-care isn’t always easy for some people with PTSD. I will propose a new trend that I would love to see sweep the internet – self-compassion. I will be steering away from making this blog COVID-related – I think we’ve all had enough of talking about it…

What is self-compassion and how does it relate to PTSD?

Self-compassion is made up of three main qualities:

  • self-kindness – simply being kind to yourself in situations where you could alternatively be self-critical.

  • common humanity – the understanding that all humans experience times in their life when they face adversity and that no-one is alone in these feelings.

  • mindfulness – being aware of the painful thoughts and feelings without being overwhelmed by them (as suggested by Neff and colleagues in 2003).

Self-compassion relates to PTSD as it has been shown that people with higher levels of self-compassion show less of the symptom of avoidance (a common symptom of PTSD). In other words, these people will naturally expose themselves to things that remind them of their trauma compared to those who have lower levels of self-compassion. This is a good thing and something that certain therapies encourage as part of the recovery. Those who already have the trait of self-compassion may recover more quickly from their PTSD symptoms or have less severe symptoms in the first place. Overall, self-compassion can’t necessarily prevent PTSD, but it can reduce its severity (as found by Thompson & Waltz in their research in 2008).

Further evidence for the relationship between self-compassion and PTSD

Fear or active resistance of showing self-compassion could cause many problems for an individual and it can lead to an inability to exercise self-care. A research paper by Forkus and colleagues found that lack of self-compassion was associated with more severe symptoms of PTSD and this was associated with greater alcohol misuse.

Although this paper only finds an association between these three factors (rather than stating that one causes the other), it explains why this particular group of people may have a fear of self-compassion. One suggestion by researchers in 2019 (McAllister and colleagues) is that the military culture is an environment in which more ‘feminine’ traits - such as being in touch with your emotions – are discouraged whereas more ‘masculine’ traits - such as emotional control and ‘toughness’ - are encouraged. These traits are almost opposite to self-compassion. This relationship between self-compassion and more severe symptoms of PTSD can explain how people with higher levels of self-compassion are more protected from severe PTSD symptoms.

So how does this relate back to self-care?

From the evidence above, we can safely say that there is an association between self-compassion and less severe PTSD symptoms. So, with this knowledge we should try and develop therapies where the treatment focus is to improve self-compassion. This could prevent PTSD and also reduce the symptoms.

Self-care could seem a distant concept to those who cannot exercise self-compassion. But maybe we need to leave the idea of self-care in 2020. Self-care is now being used as an advertising trick by companies who want you to buy their products all in the name of self-care. But self-care shouldn’t be something you have to spend money on to achieve.

In 2021, perhaps self-compassion can be the new self-care.

Tips and tricks:

What self-care should be about is looking after your body and mind. In terms of PTSD, there are ways you can look after yourself and deal with your symptoms that can help:

  • grounding techniques: pay attention to all your senses and notice your surroundings – this will help you remain in, and feel ‘grounded’ to, the present (this was found by Raja in 2012).

  • breathing techniques: take deep breaths – gaining control of your breathing will help you regulate your heart rate and reduce tension in your muscles. Calming your body will help calm your mind.

  • if you feel your mind racing or you are getting caught up in negative thoughts, such as blaming yourself for the trauma, try meditation. Headspace is a mindfulness app that has hundreds of meditative courses – try the noting exercises to clear your mind. In the sleep section of the app, there are meditations to help you fall asleep or go back to sleep if you wake up in the night.

  • try and stay connected to those you love and care about: these people are key to helping you feel better and it is always nice to speak to someone when you are having a bad day.

On a more general note, you can exercise self-compassion in the following ways:

  • Learn to say ‘no’. When things get overwhelming or you feel your productivity is being compromised by the amount you have to do, saying ‘no’ will make you feel more in control and will most likely make you more productive in the tasks you already have to do.

  • Listening to your body – if you feel sluggish or exhausted all the time; review your diet, sleeping habits and the amount of exercise you do to see if you can improve in any of these domains. It has been found by Harris in 2018 that an increase in exercise has a strong association with the improvement of mental wellbeing.

  • Be kind to yourself and forgive yourself for making mistakes – you’re only human!

  • Improving your wellbeing can also be achieved by giving to others – it makes you feel good and feel more connected to those you care about. It has been found that selflessness is highly associated with positive mental wellbeing (as stated by Hanley and colleagues in 2017).

This blog was written by Martha Dempsey – a psychology student at Cardiff University doing a placement year working for the Traumatic Stress Research Group (TSRG) in the National Centre for Mental Health (NCMH).