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 Conversations with Leaders in Self-Care: How Health Workers Can Promote Self-Care 
Interview with John W Travis MD, MPH
   as interviewed by Tom Ferguson MD

JT: So how does the model you're creating offer an alternative to all that?

By making clear the limits of responsibility of the professional÷that he or she can only assist the other person in doing things for him or herself. Being a consultant, rather than taking on the main responsibility for the other person. Also, if you're suggesting all this self-nurturing and self-care to others, it's important to practice what you preach.

I see a lot of health workers who are feeling burned out. There's a great deal of anger, a real feeling that the present system isn't working. A lot of health workers come to the workshops we give here at the Center, looking for tricks and techniques they can add to their practice. They want the five easy steps to wellness.

TF: For themselves?

JT: No, for their patients. They figure that if they can just make their patients well, they'll be okay.

TF: So do you give them the five easy steps?

JT: (Laughs.) No. We just share our own experiences and try to get them to go through a wellness evaluation themselves to think about starting their own wellness program.

You'd be amazed at how difficult it is for some health workers to start looking at themselves! They want techniques and tricks and handouts they can copy and give out to their patients. We have to say, "No. We can't give you that." And sometimes they get angry.

They expect some kind of magic formula. And what we tell them is that they've got to start by detaching themselves from the rescuer role. That seems to be the basic source of conflict for most health workers.

Health workers are trained to be rescuers, and then they burn out and come in trying to suck us into the rescuer role for them. Rescuers always end up becoming victims.

So we health workers need to start seeing clients as responsible people÷not victims÷who are making certain choices in their lives and that's okay. You can't take on the responsibility for them. It takes a very high degree of autonomy and self-confidence, and a very real sense of your own limits and the limits of medicine.

TF: The trick is to stay concerned, but not try to take on responsibility for the person's problem.

JT: Yes. And that isn't a cop-out. It's just a matter of realizing your limits. Smokers used to drive me crazy. Now it's okay with me if someone chooses to smoke÷ as long as they don't do it when I'm around. I've managed to let that one go. But if they decide they want to quit, I'll be there with suggestions, resources, a chapter in a book, or whatever.

It's not that difficult to let people take responsibility for headaches or ulcers or high blood pressure. It's much harder for, say, genetic diseases or accident victims. But you can do the same thing with them. I've been impressed by how many health workers rely on some kind of religious or spiritual belief system to support them in allowing the people they work with to be autonomous spiritual beings. We've ended up talking about religious belief and spiritual awareness at a number of the workshops. People seem to be hungry for this sort of thing. I think it's particularly important for health workers÷who are going to be communicating about this change to others÷to keep growing spiritually.

The fact that you're granting some kind of spiritual quality to people you're interacting with can't help but show. They can't help but feel that respect. They pick that up, and they'll probably respond in kind. They're going to start taking more responsibility. If our attitude is that they're helpless wretches, and if we don't do something for them, they're in bad trouble, they're going to pick that up and live that out. And then they resent you and do everything they can to defeat you.

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 About The Author
Tom Ferguson, M.D. (1943-2006), was a pioneering physician, author, and researcher who virtually led the movement to advocate informed self-care as the starting point for good health. Dr. Ferguson studied and wrote......moreTom Ferguson MD
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