2020, a year in review: Pam Withey

How has the past year been?

The past year was certainly notable! Sometimes years pass from one to the next and apart from a small number of significant events, they meld together as a continuum of time, but 2020 branched on a whole different trajectory. COVID and the related changes that occurred were sudden, unexpected, and a mass population event.

Initially, personally, my biggest concern was survival, on the “outside” I was cool calm and collected, logical and practical, but secretly inside I faced a dilemma that I think many health workers shared. I was working as a Clinical Psychologist in private practice, and I knew that my patients were vulnerable and needed additional/immediate support in a treatment mode that they were comfortable - yet ongoing direct patient contact would expose me to risk, and the fear that I would inadvertently pass this risk onto family members or my local community. It was a relief that local government and organisations took the responsibility for decision making regarding travel restriction and isolation and that the government quickly made allowances for continued patient contact via telehealth. I did feel for the frontline staff that still had direct patient contact.

I found adjusting to telehealth surprisingly pleasant, and some benefits of this mode of treatment. Some patients stated it was easier for them to tell me some private experiences that they would feel uncomfortable sharing face to face.  I found it easier to ask for more description of their experiences as I wasn’t getting the non-verbal cues. A small number of patients declined telehealth and waited for the return of face-to-face appointments, of course, this was challenging, but the majority found telehealth beneficial, were able to attend more appointments more easily, and transport to/from appointments no longer a barrier. My attendance rates went up, and this also meant working longer hours than I had planned, as administrative tasks no longer fitted into gaps between appointments.

I was very reluctant to work from home. I maintain boundaries and personal wellbeing by keeping work at work, and my commute home is a chance for reflection and mentally disengaging from work to my personal life. Even though I worked in private practice, I always think of myself as part of a team rather than a sole practitioner. To be working from home was not ideal and I was concerned with how I would cope. Reflecting back now, I can see the challenge I actually faced was different. I was able to easily “switch” between work mode and personal mode with some helpful thinking and mindfulness of my everyday tasks, turns out I didn’t need the time of a commute to/from work to achieve this.

My challenge was me, in 2 ways.

First, a challenge was my own isolation from colleagues who were no longer physically present but were certainly still available. The incidental support from colleagues when sharing the same space was lost, and I had unhelpful thoughts of “I don’t want to waste their time” or “It’s not important” that led to avoidance and professional isolation. It took a while, but I found that I needed to reach out for other sources of professional understanding and camaraderie. I found that in addition to colleagues I knew (with intentional contact rather than relying on incidental support), reading online professional forums with colleagues I have never met a source of support – thanks eMHPrac Community of Practice and APS College of Clinical Psychologists.

Second, a challenge was my blurring of work time and family time. Working from home meant that I could stop doing admin work that I would normally be doing during work time at the office for other family/home tasks (that clearly I couldn’t do when at the office), but then the fallout was logging back into work later and continuing. This was initially very good use of prioritising/planning/problem solving, and I didn’t mind as I felt I was present for things that needed my attention in a timely manner. However over time, I found it hard to have days off, my brain was continually half in work mode. I don’t think it impacted work or family, but it did impact my wellbeing as the small but important “me” time was dismissed for work things of seemingly higher importance. I put myself last.

I had to face some personal truths. I needed the structure of different environments to help me keep balance (tick), and I needed to reconsider my working hours (tick) and prioritise “me” time (ummm, work in progress). It meant reinventing my self-care routine to be more flexible, openminded, consistent, personally valued and prioritised. I became more aware of making the most of seemingly routine actions and adding value with a healthy dollop of self-care. I think realistically self-care should always be a work in progress.

I want to finish with a reflection about a mass population event. The benefits of “we are all in this together” is the greater understanding of the shared difficulty and acceptance of help-seeking. I have certainly seen higher numbers of people initiating/seeking mental health support, which is great. But I am also cautious that at some point the tide will turn and “we all went through that” will leave some vulnerable people having unreasonable comparisons “why is everyone else ok and I am still struggling”, or hearing unhelpful expectations “that was last year, you should be ok now” which will increase their distress and isolation. So fellow health practitioners – please be vigilant for those who may need a little longer support than the norm, or who may abandon help-seeking due to fear of or actual stigma.

And prioritise your self-care.

If you would like some suggestions of easy but effective positive psychology strategies you can use in your own life, why not watch our Working Towards Wellbeing video series.