Mind Matters with Dr. Sara Boilen

“Take good care.” 

It’s a common phrase: self-care. Presumably, it means to, well, take care of yourself. But what does that mean exactly and, perhaps more importantly, how do you do it? 

Self-care, or perhaps better: mental hygiene, is the art of attending to your psychological wellbeing. Much like oral hygiene, self-care is preventative. In this case, however, rather than avoiding a cavity, you’re fending off days spent in bed hiding from the world (not that sometimes that isn’t the exact right thing to do). 

Self-care matters because it creates optimal health, functioning, and engagement. No one celebrates the day when their hygiene routine has slipped, and their face breaks out. Similarly, none of us feel great when the stresses of life catch up to us and leave us experiencing an anxious dread that gets in the way of participating in life. 

The thing about our mental wellness, much like our physical health, is that we rarely notice it until it’s missing. Since last March, many of us (maybe all of us?) have had moments where we were not living our best lives. We have felt anxious, worried, or, if you’re anything like me, despondent and despairing about our shared future as a society. Oh, that’s just me? Cool.  

And while a good self-care routine is not foolproof, it’s our best weapon against psychological ruin. Just like washing your hands and sleeping well may stave off the common cold, so too can mental flossing prevent breakdowns and the occasional existential panic. 

So, how do you self-care? 

Self-care can be broken down into two main approaches. The first: preventative care includes the regular habits we have that maintain our mental health. These are things like taking walks in nature, bubble baths, petting your dog, doing the crossword puzzle, or going to see a therapist. These strategies are not designed for surviving a mental health crisis but are, instead, aimed at staving one-off. The second category is designed for those moments of despair. Mental health crises can include trips to the ER for suicidal ideation, but they can also include panic-inducing moments just before walking into a party, or the creeping and festering anxiety that grows around a stressful work meeting looming on the horizon, or the two-a.m. bathroom trip that ends with several hours of ruminating on that terrible and stupid thing you said last week at the office meeting. A crisis, as I’m calling it, is just a moment that feels un-endurable. And we can use self-care strategies like box breathing, counting to 27, or allowing an ice cube to melt in the palm of our hand, to help us endure. 

So, if you’ll humor me, and I hope you will, jot down five things that maintain your mental wellness. These things should be diverse and practical. Don’t write down soak in a hot tub if you don’t own or have access to one. They should be things you enjoy and can fit in your daily or weekly routine. I’ll go first: 

5 things I can do to stay well: 

  1. Spend time with my loved ones. 

  2. Dog walks.

  3. Thera-baking (it’s just baking but it feels like therapy).

  4. Reading good books that have nothing to do with the state of the world. 

  5. Plan adventures (I really enjoy planning almost as much as doing).

Now, flip the paper over, or if you’re using your notes app on your phone, just start another list for the five things that you can do to get yourself back on track when things feel like they’re starting to get overwhelming. These should be things you can do most anywhere, anytime, perhaps without even anyone else noticing. Please, for your sake, leave shots of whiskey off the list. While everything is good in moderation, we want to see things on this list that won’t depress your psychological system. Again, here I go: 

5 things I can do to get back to well: 

  1. Mountain breathing (with my eyes I trace a hillside, tree, or even building. As I move up one side, I inhale. As I move down the other side, I exhale. This grounding technique uses multiple parts of my brain to de-escalate my nervous system).

  2. Describe 5 things I can see, 4 things I can hear, 3 things I can feel, 2 things I can smell, and 1 thing I can taste (today, it’s the last sip of my morning coffee). 

  3. Write down the things I’m swirling about on a to-do list and then put that list aside and go back to bed (I find that the ruminating can be stopped when I just get the thing out of my brain and onto the paper. I can look at it in the morning and decide what to do about it when I’m thinking clearly). 

  4. Count backward from 100 by 7’s. (again, we’re engaging the parts of our brain here that aren’t responsible for fear or pain and distracting ourselves away from the source of distress. It’s challenging but entirely doable). 

  5. Notice my feet and plant them firmly on the ground (again, grounding, literally).

I find it especially helpful, as with most things, to practice these skills when things are going smoothly so that when you hit the bumps, they don’t buck you completely. 

Written by Dr. Sara Boillen

Mountain breathing self regulation exercise
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