First published in Mindnet Issue 11 – Spring 2007
Recently I’ve come through a series of life changing stresses and learned what true love; friendship and personal strength were about. In particular the words of wise Rabbi Hillel, a Jewish scholar & theologian who lived from 30 BC – 9 AD have been a source of inspiration for a previously uncharted journey: “If I am not for myself, who will be for me? If I am not for others, what am I? And if not now, when?” Dan Baker and Cathy Greenberg suggest using these questions to prompt you on a daily basis. Despite being written so long ago, these words have stood the test of time and got me thinking about how we can maintain good mental health amidst transition and change. Two transitions that have occupied a great deal of my energy and interest have been the transition to parenthood and the transition to living in a new country.

If I am not for myself, who will be for me?

Starting with question one, If I am not for myself, who will be for me? Baker argues that we have to take good care of ourselves and begin by having a good relationship with ourselves and being our own best friend. There are some things that only we can do for ourselves and some things that we can delegate. They recommend asking yourself further questions every day: such as what I have done to take care of my body, mind and spirit today? Both new parents and new migrants experience the loss of otherwise familiar reference points. New mothers face the demands of an unpredictable gamut of demands for a baby whose needs are all-consuming and leave little time or energy for focusing on oneself. For a migrant, the loss of a “village” and familiar things, places and processes often leads to a quest for belonging and clarification of values and purpose. Both transitions offer the potential of transformation provided resources and support are in place, but accessing them can often be difficult.

If I am not for others, what am I?

Question two leads us from taking care of ourselves to taking care of others. If I am not for others, what am I? Research evidence is growing that social support is critical to successful coping through enhancing resilience, buffering the impact of stress and assisting in the maintenance of positive mental health. Social support encompasses four key attributes emotional (e.g. providing empathy, caring, love, and trust), instrumental (e.g. aid in kind, money, labour, time, and modifying environment), informational (e.g. advice, suggestions, directives, and information) and appraisal (e.g. affirmation, feedback (Toljamo & Hentinen, 2001) and results in improved mental health (Finfgeld-Connett, 2005 ). Often support starts with one’s immediate family and then to friendships termed ‘central helping system’ by (Canavan & Dolan 2000 cited in (Pinkerton & Dolan, 2007)) and often it is only when this support is exhausted, weak or unavailable that people approach more formal sources of support.

In terms of my two professional interests, I have found that when people migrate they frequently lose their support networks and when people welcome a new baby into their family they frequently have to develop alternative support networks. Social support is characterised by reciprocity and mutuality and involves the exchange of resources between people that enhance the well-being of both. When we are supported and become part of a network of communication and mutual obligation we can begin to believe that we are cared for, loved and valued (Hupcey, 1998).

If not now, then when?

Question three asks us “if not now, then when?” This is where a focus on the present moment becomes highlighted. For so many of us the focus is on the future. For the new migrant it can be about “when I get the job that recognises my qualifications and worth then I can start enjoying my life in this new country”. For a new parent it might be “when I can sleep through the night I’ll start enjoying being a parent”. How can we feel good in ourselves, when things feel out of control, unresolved and unresolvable? Mindfulness, a Buddhist concept based on becoming aware of the moment and living fully in it regardless of how pleasant or unpleasant it is can lead to transforming that reality and your relationship to it (Kabat-Zinn, 1993). Ultimately there is very little we can do about what has already happened or determine the future, but the likelihood of a wonderful future is enhanced by thoroughly enjoying the present.

Mental health awareness week

Which leads me to the theme of this year’s mental health awareness week, good mental wellbeing can come from:

• Celebrating our uniqueness
• Connecting with each other
• Supporting others in their journey
• Sharing our stories

So how can we celebrate our uniqueness when there is little to support our identity? How can we connect with each other, when we are isolated? How can we supporting others in their journey, when we ourselves are un-resourced? How can we share our stories if there is no one to listen?

Key points to consider for mental health and health promotion workers and organisations.

There is a need for mental health service providers to both safeguard quality care and ensure continual improvement of the quality of their services by creating an environment where they, their colleagues, their clients and family members can flourish. One of my own favourite strategies is supervision which helps me both with my self-care, self-development and ensuring I get the support that I need. It also helps me develop and increase my knowledge, understanding and skills. Again I’d like to reiterate Rabbi Hillel’s first question. How can we truly care for others if we don’t care for ourselves? Self-care is so under-rated, but if you are a mental health worker ask yourself: How do we I look after myself and cultivate my own wellness? And how can I practice what I preach?

In terms of your own support network. How can you avoid working in isolation? How can you get the support that you need? If you aren’t thinking about this it can be difficult to consider the needs of people and groups that require support to remain socially included. How do you encourage clients/tangata whai ora to use and enhance their own personal support networks? In reflecting on Hillel’s third question, consider how can you be fully present with your mahi. How can you be so fully engaged in your work that it provides a well of energy that is renewable and deeply satisfying so that you don’t get burned out. How can you ensure that your work and efforts are sustainable? For me it goes back to attending to myself regularly, meeting my own needs, considering my own health and well being.

My central helping system undergoes continuous refinement but what I have realised is that it requires me to first have a relationship with myself. Only then can I have an effective relationship with anyone else. Then ensuring that I have a support network in which reciprocity reigns and lastly being fully present with myself (not always easy). Rabbi Hillel’s questions provide a useful starting point for considering our own mental health and of those who are part of our lives personal and professional. Attending to these three questions provides us with accessible resources for mental well being.

REFERENCES

Finfgeld-Connett, D. (2005 ). Clarification of social support. Journal of Nursing Scholarship 37(1 4).

Hupcey, J. E. (1998). Clarifying the social support theory-research linkage. Journal of Advanced Nursing 27(6), 1231.

Kabat-Zinn, J. (1993). Mindfulness meditation: Health benefits of an ancient Buddhist practice. In D. Goleman & J. Gurin (Eds.), Mind, body medicine : how to use your mind for better health (pp. 259–276). Yonkers, N.Y.: Consumer Reports Books.

Pinkerton, J., & Dolan, P. (2007). Family support, social capital, resilience and adolescent coping. Child & Family Social Work, 12(3), 219.

Toljamo, M., & Hentinen, M. (2001). Adherence to self-care and social support. Journal of Clinical Nursing 10(5), 618.