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Down the Rabbit Hole
Paul Kiritsis, PsyD Clinical Psychology, DPhil., MA (History)


Professional Development: The Clinician's own Self-Care

Paul Kiritsis - Tuesday, December 16, 2014

With respect to a clinician’s own self-care, the importance of maintaining a balanced lifestyle cannot be exaggerated. In the Pocket Guide to Interpersonal Neurobiology, Siegel expounds upon seven mental activities that will promote neural and interpersonal integration when time is shared equally between them: the deployment of focal attention; the engagement in playful, vigorous, and spontaneous activities; the construction of social relationships; the involvement of aerobic and kinaesthetic motion; inner contemplation and reflection; nongoal-directed attention or ‘down time’; and sleep.

The last is undoubtedly the most important factor in the maintenance of mind-brain-body balance and fitness. By inducing automatic change from the energy-expensive ergotropic to the energy-conservative trophotropic state, sleep conserves the amines (serotonin and norepinephrine) responsible for activation of cortical networks and the sympathetic branch of the autonomic nervous system. Moreover, it’s impossible to ignore the obvious connection between REM-bound sleep and the body’s immunological response to viral and bacterial infections and the formation of cancerous tumours. Scientists who have studied the effects of sleep deprivation on rats and other animals in laboratories with the sturdiest of empirical controls find, time and time again, that lack of sleep and above all REM-mode sleep, leads to the involuntary loss of brainstem functions like temperature control and the apt mobilization of natural defences. Depriving someone of sleep on an ongoing basis can and will initiate a lethal downward roll into the decadence of low energy, foul mood, depression, psychosis, long-term organic disease due to neuronal apoptosis, and inexorably clinical death. During our lifetimes, we must make it our sacred mission to avoid activating this sequence of deleterious reactions at all costs!  

At the end of the day, the most important piece of information scientific humanism impart to any living being is to listen to the language of your own body and respond appropriately. When tired get some rest; when wakeful rise and embark on something constructive; and when hungry feed your body a nutritious, balanced meal rich in protein, slow-release carbs, and unsaturated fat but low in sugars and saturated fat. Keep alcohol consumption to a minimum and remain hydrated at all times. Practice mindfulness-based interventions, whether that is some form of martial arts, song, dance, guided imagery, self-hypnosis, empathy and compassion, or meditative practice, and remain grounded in the present moment. Avoid uselessness and pointlessness at all costs, something each and every one of us does when we loiter about in artificial reconstructions of the past or the would-be of the future. Refrain from overthinking. Make moderation an adage to live and breathe by and avoid rigorous mindsets which demand ‘in excess’, even when the collective imperative decrees it is good for you.

On a different note rampant and religious overemployment of supposed beneficial attitudes and behaviours are equally unhealthy. Life can get fairly complicated so make every attempt to keep it as simple as possible. Keeping to the basics is our best bet for success. Due to differences in our genetic and phenotypic blueprints, there can never be one right prescription for leading a balanced lifestyle; each individual must find one that harmonizes with her natural constitution. To give a random example, some people require more than the average seven to nine hours of sleep per night to function efficiently and effectively. Food intake is another one which varies considerably from person to person; if you’re an avid body-builder, swimmer, or jogger your calorie intake is bound to be higher than somebody for whom exercise is as foreign as the fourteen gaseous moons of Neptune. Volitional adherence to these basic principles coupled with reason for being will ensure that your biorhythms remain in homeostatic balance, and that your body never gives up on you before its time. You, and only you, are responsible for your wellbeing.

Know thyself.    



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