Wellness for Care Providers: Surviving the Cycle of Caring

Caring professions, also called helping professions, are those where the role means directly caring for others physically, mentally, or emotionally. Some of the most common caring professions include nurses, teachers, social workers, and mental health therapists. 

When you work in a caring profession, there can sometimes be a disconnect between how you care for others and how you care for yourself. It’s easy to give too much and not refuel yourself when you need it, which can quickly lead to burnout.

To ensure a healthy balance and care for both yourself and others, it’s important to understand the cycle of caring and create a plan for managing your self-care. In this blog, we’ll explain the four stages of the cycle of caring and show you how to begin assessing the stressfulness of your job so you can best take care of yourself. 

Ciera Jackson, our Professional Development Specialist here at Cummins, shares her expert advice about the cycle of caring and creating a solid self-care plan for your own personal wellness.

(Ciera Jackson, MSW, LCSW, Professional Development Specialist at Cummins Behavioral Health)

Explaining the Cycle of Caring

The cycle of caring is the process that happens when professionals, such as therapists, provide help to clients without receiving help in return. 

This process happens continuously in the helping professions because clients come and go. The therapist helps the client, the client puts the lessons into action, and then the therapist has to let go of that relationship because they’re no longer needed.

There are four stages of the caring cycle: empathetic attachment, active involvement, felt separation, and re-creation.

Empathetic Attachment

The first stage of the cycle is all about building rapport. During empathetic attachment, the practitioner must be open to what a client needs and be emotionally compassionate. Ciera explains, “This is the phase where you’re building rapport with a client, the client is emotionally vulnerable with you, and where you’re other-oriented.”

The empathetic attachment phase requires you, as someone serving another person, to be “on” and lend yourself to other people. It’s all about connection and trust.

Active Involvement

After empathetic attachment, the next stage is active involvement, which is where the professional invests time and energy to use their skills in helping the client. This is the phase most caring professionals spend the most time in. 

It’s the phase where professionals must figure out what the client needs, whether that’s assistance with anxiety, depression, social skills, or relationships. Ciera notes, “You have to reach for all these different tools in your tool bag.”

Active involvement is also about making coping tools accessible to people who may not understand them or be overwhelmed by where to start. “It’s our job to help them simplify it. That’s what we have to do in the active involvement phase. We have to simplify things for them so it’s not so overwhelming,” Ciera says.

Ways to Build Your Practitioner's Problem-Solving Toolbox– Read books or listen to informative podcasts

1. Have conversations with other practitioners and learn what works for them
2. Look for ideas on social media, especially among practitioner-focused groups
3. Utilize reference websites for therapists, such as TherapistAid.com
4. Watch videos from well-known practitioners and therapists on YouTube
5. Sign up for paid trainings
6. Attend staff events, when offered

Felt Separation

During felt separation, the professional’s work is complete. The client applies what they’ve learned, and the practitioner detaches themself from the relationship. No matter what kind of role a professional fills, there are bonds created with the people they regularly serve, which means almost everyone in a caring field feels separation at some point.

This separation isn’t always easy. Ciera says, “Sometimes it’s very uncomfortable, and sometimes it’s bittersweet because you have an attachment to them. It can be a great attachment, but you are not in their life permanently, and that’s a good thing. That’s a great thing.”

Re-Creation

As the caring cycle ends for one relationship and the separation is finalized, a caring professional should take time for re-creation. “Get some rest. Get away from work, hit the ‘off’ button. That’s what should happen in this cycle,” Ciera emphasizes. 

For many people, this can be a challenge because of the pressure to be constantly productive and on the go. Ciera tries to remind herself and her co-workers, “I need to shut it off. I need to shut it down. I need to prioritize myself, because you can’t pour from an empty cup. You can’t give what you don’t have and you can’t run on fumes.”

Ciera adds, “Sometimes people don’t give themselves permission to take the time to rest, because even when they’re resting, they feel like they should be doing something and making themselves busy. When you don’t rest, your body starts to give warning signs that say ‘Attention, I need you to stop.’ ”

Care and the Practitioner

Generally speaking, we know what happens for the client during these phases, but what’s happening for the practitioner? How are they responding and coping with the stresses and different stages of the caring cycle? 

Caring is a precondition for an effective helping relationship.

Ciera puts it plainly: “If you’re going to be effective in your work, you have to care.” For caring professionals, caring is quite literally part of the job, and that feeling must exist for them to do well and care for others in an effective way.  

Inability to care is the most dangerous signal of burnout, ineffectiveness, and incompetence. 

If you find yourself in a situation where you don’t or can’t muster a feeling of caring, “that likely means you’re burnt out, which means you’ll be ineffective and incompetent,” Ciera says.

Low points and burnout occur for everyone, regardless of what your role may be. However, as a caring professional, it’s essential to rejuvenate before you find yourself unable to care. Ciera encourages, “If you feel in your spirit that you don’t care, take a little break. Take a little leave of absence because that’s not how you should feel.”

She also points out that you should try to avoid reaching a point where your work and character are deemed questionable, or where people wonder whether you’re competent, because these doubts can follow you into the future.

Sustaining oneself, being vital, and being active in the caring professions means being fully present for the Other.

When you’re providing care to others, it’s important to be present and in the moment. “We to be fully present for the people we are working with,” notes Ciera. The clients are counting on you, and it’s your job to ensure you have the capacity to provide the care they need. That starts by taking care of yourself. 

Repeatedly, a practitioner must engage in a mini-cycle of closeness with the consumer and  grief over the end of the professional relationship.

“This is what we do. We get close and then we have to let go,” Ciera says. The cycle can be difficult for practitioners because some relationships and bonds are very strong. While this is great for facilitating helping, it can also make it more difficult to let the relationship end.

Strategies for Surviving the Caring Cycle– Release pent up emotions (crying is OK):

1. Talk about it with someone who has experienced it and who has been in the field for awhile
2. Recall the nature of the cycle and work on viewing it from an "outside" perspective
3. Always remember that you make a difference in the lives of your clients

The Self-Care Action Plan

As a caring professional, you need to make sure to leave enough time for self-care. A Self-Care Action Plan can be an invaluable tool toward this end. At Cummins, we use a Self-Care Action Plan template inspired by the book The Resilient Practitioner: Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers, and Health Professionals by Thomas Skovholt and Michelle Trotter-Mathison.

In the remainder of this post, we’ll go over the first two steps of creating your Self-Care Action Plan: assessing your work stress and determining what kind of self-care/other-care balance you have in your life right now.

Step #1: Assess the Stress Level of Your Work

Work stress can be determined by assessing three factors: Demand, Control, and Social Support.

First, consider the following questions to assess the Demand of your work:

• Do I have to work very hard for my job?
• Am I asked to do an excessive amount of work?
• Do I have enough time to get my work done?

Based on your answers to these questions, give yourself a rating from 1–5 for how demanding your work is, with 1 being low demand, 3 being moderate demand, and 5 being high demand.

Next, assess the Control you have in your work by considering:

• Do I have to do a lot of repetitive work?
• Do I have much freedom to decide how my work gets done?
• Do I get to be creative in my work?
• Do I get to learn new things for my work?

Use your answers to give yourself a rating on how much control you have over your work. Again, let a score of 1 indicate low control and a score of 5 indicate high control.

Finally, assess your level of Social Support by asking yourself:

• Do I work with helpful people?
• Do my co-workers take personal interest in me?
• Is my supervisor helpful?
• Is my supervisor concerned about my personal welfare?

As you did for Demand and Control, give yourself a rating from 1–5 indicating how much social support you receive in your work.

Once you’ve determined all three scores, you’ll have a better picture of exactly how stressful your work is. High demand, low control, and low support all tend to increase job stress. By contrast, the least stressful jobs combine high control and high social support with low demand.

Step #2: Give Yourself a Balance Score

Once you’ve determined how stressful your job is, consider how much you care for others versus yourself. Ask yourself: Do I tend to give more other-care and less self-care? Or do I tend to give more self-care and less other-care? Or am I about even?

Determine your current ratio of self-care to other-care. For example, if you are perfectly balanced, your score would be 50/50. If you are highly imbalanced, your score might be 90/10 (90% self-care to 10% other-care) or 10/90 (10% self-care to 90% other-care).

Once you’ve determined your balance, think carefully about any imbalances you see. If you find that you have a very unbalanced score, consider: What are some of my imbalances? Why am I out of balance?

These questions can be informative and enlightening  when it comes time to determine the wellness practices that will help you correct any self-care/other-care imbalances.

For caring professionals, caring about other people is part of the job description. This can result in work that is personally rewarding and deeply fulfilling. It can also create situations that are highly stressful and emotionally exhausting.

Fortunately, having a Self-Care Action Plan can help caring professionals balance the demands and responsibilities of their work. In future articles in our series on Wellness for Care Providers, we’ll explain how you can improve your self-care practices, focusing on areas like professional care, personal care, and physical care. Stay tuned!