One veterinarian’s tai chi journey amidst the pandemic
What is self-care?
Self-care is the first step in one’s overall health. Veterinarians must maintain good health, remain open-minded, and take care of themselves well, so we can stay sharp for our patients.
The International Self-Care Foundation suggests seven pillars in their framework to describe self-care. See Figure 1.1
The foundation feels that self-care is part of everyday activities. They believe that for the individual, it is “a practical, person-centred set of activities that we should all be undertaking to maintain our health, wellness, and well-being.” 2
The World Health Organization chooses to define self-care as “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider”.3
Sadly we live in a time where worldwide, people struggle with self-care. Taking care of our own mental health and physical requirements need to be paramount. To properly take care of others — whether 2 or 4-legged family members, friends, or our patients, we need to care for ourselves.4
When we are feeling self-critical, guilty, lonely, anxious, frustrated, angry, ashamed, upset, you name it, this tells us that we haven’t partaken in appropriate self-care. But it is never too late to start taking action. Think of self-care as a means to express self-love.5
The importance of self-care for veterinary professionals
If you have read any of my previous articles, you know that I am a proponent of One Health, and this topic fits right in line with a One Health theme. Mindfulness, self-care, and well-being are critical in today’s stressful veterinary climate.
Veterinary suicide rates are at all-time highs, and the veterinary community is finally stepping up and recognizing that warranted interventions are essential to prevention. Promoting self-care and well-being moves towards a healthier workforce both individually and collectively.
How to practice self-care
Sometimes self-care practices seem to feel like things we should do, not something we want to do.
Getting started in self-care activities such as practicing mindfulness can seem like a chore rather than a respite. On starting out with Headspace (a meditation app), I felt I needed to improve my overall state of health. Sadly, it took me almost eight months to incorporate it into my daily routine. If I fail to do it, I notice a difference in my overall demeanor and focus for the day.
Instead of being a should, mindfulness practice became something I wanted to do. Activities like practicing tai chi, regular meditation, or picking up a book for pleasure, were pursuits I chose to pursue and would benefit my overall well-being.
Many self-care activities emerge to help one cope with life’s stressors, relax, and grow mentally, physically, and emotionally. From physical exercise to meditation to reading a book, activities inside and out exist to help us cope with life’s trials and tribulations.
A plethora of apps for various devices exists for this very purpose.5,6
See Figure 2 for a more complete list of suggestions, though the list really could be endless. Select choices include:
- Practicing mindfulness/meditation – I have made Headspace a part of my daily morning routines. Without it, I can be moodier and sometimes feel lost. Some days more than others, it can be more of a struggle to get out of my head and let thoughts go. But with daily practice, I learn more about myself and how to manage day-to-day. Somedays, I just remember to stop and breathe.
- Daily positive — Write out a positive experience from your day. Attach a positive emotion like pride, contentment, or optimism and grade it out of 10, with 10 being the best. Somedays, you may have to search deep to find that positive, but I never go to bed without reflecting on at least one positive in my day.
- Daily affirmations — End your day by writing down three things you are grateful for. This helps remind you all that was good about your day, profession, family, friends, and even your life. Striving for a more positive outlook can be a struggle for me. By doing this nightly, I go to bed on a positive note and affirm that there is always something to be appreciated in this crazy world.
- Coloring —Adult coloring books are big now! Go figure. Who would have thought that coloring in the lines would be soothing? But for me, many an emergency overnight shift was made easier by a few minutes respite to color in the lines.
- Exercise – For some, this may be a complete aerobic workout. For others, yoga, Pilates, practicing tai chi or another martial art, or simply going for a walk may be what the doctor ordered.
- Stop and breathe — Sounds silly, right? But I cannot tell you how often I feel a knot in my stomach while working a complex emergency or dealing with a troublesome client. Often, I’ll pause, realizing that I’ve been holding my breath. To relax and take a moment, I will usually breathe in for a count of 5, hold 5, and out for a count of 5 to 8 seconds, but you can do what feels comfortable for you. It is amazing how much better I feel, and it gives me just a few seconds to pause and do something for myself.
- Watch a movie. If you are like me, you are almost always doing more than one thing at a time. Even if I watch TV, I usually play on my phone or do a puzzle or something else. However, when my husband and I decide to rent a movie, the lights are off, we are cuddling with our wonderful dog Jazzy, and our laptops and phones are put away. Being fully engaged in the activity makes us appreciate the downtime that much more.
Self-care and wellness resources
How often we practice self-care behaviors varies with each individual. Some activities may be warranted daily, while others perhaps a few times a week or once a month. The frequency varies with the type of activity, the needs of the individual, and other factors.
Many resources exist to help one practice self-care behaviors. From mindfulness apps on phones and tablets to Facebook groups, even a self-care platform specifically for veterinarians called the HappyVetProject.7
The AVMA has self-care information and has been making a concerted effort to improve the overall well-being of the veterinary community. Check out the AVMA’s additional resources to provide further information on self-care and options for you.
Tai Chi – One veterinarian’s self-care go-to
What is tai chi?
Tai chi utilizes low-impact movements flowing from one into the other, combining physical activity with mind and breath control to achieve greater awareness and well-being. The meditative movement was originally developed as a martial art for self-defense. However, it has evolved into much more than that.8,9
Ironically, while writing this article, the original Karate Kid movie played in the background. (I work better with background noise, and my husband was enjoying a blast from the past). Do you remember the scene where Danny is doing chores for Mr. Miyagi, who tells him to show him sand the floor, wax on and wax off, and paint the fence? Danny’s skills from those chores are actually tai chi, not Karate, just FYI.
Many movies show actors doing tai chi forms as they can be visually eye-pleasing and seem like art in motion. Often, actors perform the forms or exercises in tranquil settings, suggestive of times of relaxation and personal self-reflection.
Tai chi’s health benefits10–15
Tai chi provides one with a myriad of benefits. A true mind-based practice, Xu et al. describe how it emphasizes the “mental control of concentration in a mindfulness way.” 16(p4) The practice has been shown via scientific studies to improve muscle strength, balance, conditioning, and flexibility.
Tai chi helps to improve self-awareness by using breath and mind coordination in conjunction with the body. Improving one’s ability to know where the body is in space, tai chi helps decrease one’s risk of tripping and even improves posture. Some studies show tai chi aids in back pain management and positively impacts memory function, cognition, and psychological well-being.
Additional benefits include improvements in
- Cardiovascular fitness
- Muscular strength
- Heart function
- Mental health
- Blood pressure
- Heart rate
- Sleep quality
Finally, tai chi can act as adjunct pain management for chronic pain. Peng17 discusses tai chi’s ability to help with chronic pain via adaptive exercise, meditation, and the interaction of the mind-body unit. It can help with migraines/headaches, low back pain, and more. I have several exercises that I will do if I feel a headache coming on, often preventing one from coming to fruition.
Tai chi helps one to integrate mind and body while incorporating balance, strength, and mindfulness. In addition, the imagery and presentation, art in and of itself, is like a well-choreographed dance routine but much more. Tai chi’s many potential health benefits show it a valuable choice for self-care in many facets to improve well-being.
Because tai chi can be done at any pace or speed, it can be performed seated or standing. Even those with limited mobility can reap tai chi’s benefits. So, don’t discount it if you have underlying arthritis or other concerns. You can modify your practice as little or as much as needed.18
A final aspect to tai chi, which few remember, is that tai chi is also a martial art. Along with the health benefits the activity provides, it also teaches one the means of self-preservation. By teaching how to respond to threats and gaining mental and physical strength, one can gain a sense of security, knowing they can protect themselves from harm.
While scientific studies show low to moderate evidence supporting tai chi’s benefits, tai chi remains an area of ongoing research. Its role in health improvement and self-care will likely continue for years to come.
The daily grind of life and working took its toll on my body and mind. I have chronic pain issues and gastrointestinal frustrations. I needed the means to strengthen my body improve posture and balance, and I craved social connectedness. This is my story of a veterinarian discovering personal well-being through Tai Chi.
For years, my husband, Scott, an internist, said that he thought I would benefit from tai chi and excel at it. For years, I procrastinated and had excuses as to why not. I did a trial class in December 2017.
But it wasn’t until January 2019 that I finally started classes. I found myself enjoying a new activity for the first time in a long time. I met great people and found support and peace of mind.
Fast forward to March 2020. The COVID-19 era made tai chi classes a bit impersonal and zoom-based. However, it provided an outlet despite the social distancing and confinement.
In 2021, surgery and subsequent osteomyelitis complications had me on the sidelines for many months. When I returned, albeit virtually, my classmates and Shifu (instructor) welcomed me openly with sincere well-wishes.
Fast forward to January 2022. I am currently a silver sash and hope to test for black in March, an accomplishment of which I am proud. Through the practice of tai chi and with the help of my instructors, I have gained strength and mental acuity. Without tai chi and the people with me on this journey, persevering through this pandemic would have been that much more challenging.
Reasons for my seeking out tai chi included achieving improved balance, bone-strengthening benefits, and improving my overall mental health. Additional benefits to the exercise strengthening and aerobic components included meeting people and feeling connected to others of varied backgrounds, ages, and life experiences.
Tai chi as healing
For years, I have struggled with physical ailments. I was a dancer for 14 years in my youth, once a firefighter, and someone who would physically try almost anything. Mentally, I love to be physically active. But each time I found a new passion and advanced with a skill, my body would defeat me, telling me I couldn’t continue with the activity. Until I found tai chi.
Suffering from chronic health conditions alone can be daunting, frustrating, debilitating, and disappointing. With tai chi, I have had to take a few breaks here and there to allow my body to heal, but I always pick right back up and feel all the better for it.
These breaks only remind me how much tai chi practice benefits me. Not surprisingly, but upsetting, my balance, flexibility, and other parameters worsened with a recent injury and over two weeks off. Still, I can already feel the improvements returning since starting back up.
When chronic conditions interfere with one’s ability to participate in life’s activities, it makes it all that more disappointing and frustrating. Couple this with the trials and tribulations of veterinary medicine and general life activities (or lack thereof, thanks to COVID).
It sets one up for disappointment, sadness, depression, migraines, and more. I sought an outlet for my frustrations and struggles. I sought out a way to help myself to improve both mentally and physically.
Despite my delay in starting tai chi, I am grateful that I did and will never look back. With my black sash test fast approaching, I have something to look forward to and a goal unrelated to veterinary medicine, freelance work, or public health moving forward.
While low to moderate scientific evidence backs up many of the health benefits purported, including cardiovascular fitness and others, I can attest first-hand to the general benefits of well-being. More studies are needed for true scientific support.
Still, I don’t need science to know the advantages tai chi grants to my overall health. Not to mention not everything in life must have high-grade scientific evidence. Sometimes it is worth making choices simply because the activity seems fun, or you enjoy it.
What can you do to improve your self-care?
Practicing self-care isn’t going to prevent burnout alone but may help. What self-care can provide you is an outlet to deal with stress, unhealthy thoughts, harmful activities and allow you to be mindful. Self-care may include mindfulness practices, a bubble bath, or a glass of wine to unwind for some. Others require participating in physical activity.
Maybe you need to pound on a punching bag or do some hot yoga, perhaps you are like me, and you need to use tai chi as both a mental and physical release. Whatever your pleasure, make sure to take care of yourself.
I used to feel guilty about relaxing, I still struggle with it. Working primarily from home currently, I feel like I should be productive 24/7 because I am not bringing home the big bucks. But, taking care of household duties while working from home doesn’t make me any less deserving of self-care than someone who works out of the house multiple days a week.
So, the first step in self-care is recognizing that we all deserve it. We all need some type of activity that allows release.
Achieving relief from mental stress, physical stress, relationship conflicts, or even just the day-to-day grind, as we all adapt to what has become our new norms, is critical to our overall health. We all must recognize and accept (which for many veterinarians isn’t easy) that before we can fully take care of others, we need to take care of ourselves.
Erica Tramuta-Drobnis, VMD, MPH, CPH is the Founder & CEO ELTD of One Health Consulting, LLC, as well as a freelance writer, consultant, researcher, public health professional and small animal veterinarian.
For self-care resources, through the AVMA, click here.
More from IndeVets:
- International Self Care Foundation (ISF). The Seven Pillars of Self-Care. International Self Care Foundation (ISF). Accessed January 18, 2022. https://isfglobal.org/practise-self-care/the-seven-pillars-of-self-care/
- International Self Care Foundation (ISF). A Manifesto for Self-Care. International Self Care Foundation (ISF). Accessed January 29, 2022. https://isfglobal.org/a-manifesto-for-self-care/
- World Health Organization (WHO). What do we mean by self-care? World Health Organization. Published 2022. Accessed January 29, 2022. http://www.who.int/reproductivehealth/self-care-interventions/definitions/en/
- International Self Care Foundation (ISF). What is Self-Care? International Self Care Foundation (ISF). Accessed January 18, 2022. https://isfglobal.org/what-is-self-care/
- Regan S. What “Self-Care” Really Means & 37 Ways To Practice It Daily. MBG Mindfulness. Published December 8, 2021. Accessed January 18, 2022. https://www.mindbodygreen.com/articles/self-care-ideas
- Glowiak M. What is Self-Care and Why is it Important For You? Southern New Hampshire University. Published April 14, 2020. Accessed January 25, 2022. https://www.snhu.edu/about-us/newsroom/health/what-is-self-care
- LIVISTO. LIVISTO launches self-care platform for veterinarians HappyVetProject. CISION PR Newswire. Published January 18, 2022. Accessed January 18, 2022. https://www.prnewswire.com/news-releases/livisto-launches-self-care-platform-for-veterinarians-happyvetproject-301462779.html
- Solloway MR, Taylor SL, Shekelle PG, et al. An evidence map of the effect of Tai Chi on health outcomes. Syst Rev. 2016;5(1):126. doi:10.1186/s13643-016-0300-y
- Mayo Clinic Staff. Why try tai chi? Mayo Clinic. Accessed January 25, 2022. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/tai-chi/art-20045184
- Haley C. 3 Tai Chi Moves for Beginners to Bring Calm to Stressful Days. LIVESTRONG.COM. Published April 17, 2020. Accessed January 25, 2022. https://www.livestrong.com/article/431042-tai-chi-basic-steps-for-beginners/
- Zheng G, Li S, Huang M, Liu F, Tao J, Chen L. The Effect of Tai Chi Training on Cardiorespiratory Fitness in Healthy Adults: A Systematic Review and Meta-Analysis. Brucki S, ed. PLOS ONE. 2015;10(2):e0117360. doi:10.1371/journal.pone.0117360
- Wu Y, Wang Y, Burgess EO, Wu J. The effects of Tai Chi exercise on cognitive function in older adults: A meta-analysis. J Sport Health Sci. 2013;2(4):193-203. doi:10.1016/j.jshs.2013.09.001
- Wang F, Lee EKO, Wu T, et al. The Effects of Tai Chi on Depression, Anxiety, and Psychological Well-Being: A Systematic Review and Meta-Analysis. Int J Behav Med. 2014;21(4):605-617. doi:10.1007/s12529-013-9351-9
- Hui SS chuen, Xie YJ, Woo J, Kwok TC yui. Practicing Tai Chi had lower energy metabolism than walking but similar health benefits in terms of aerobic fitness, resting energy expenditure, body composition and self-perceived physical health. Complement Ther Med. 2016;27:43-50. doi:10.1016/j.ctim.2016.05.006
- Jahnke R, Larkey L, Rogers C, Etnier J, Lin F. A Comprehensive Review of Health Benefits of Qigong and Tai Chi. Am J Health Promot AJHP. 2010;24(6):e1-e25. doi:10.4278/ajhp.081013-LIT-248
- Xu S, Baker JS, Ren F. The Positive Role of Tai Chi in Responding to the COVID-19 Pandemic. Int J Environ Res Public Health. 2021;18(14):7479. doi:10.3390/ijerph18147479
- Peng PWH. Tai Chi and Chronic Pain. Reg Anesth Pain Med. 2012;37(4):372-382. doi:10.1097/AAP.0b013e31824f6629
- Zhao J, Chau JPC, Lo SHS, Choi KC, Liang S. The effects of sitting Tai Chi on physical and psychosocial health outcomes among individuals with impaired physical mobility: A systematic review and meta-analysis. Int J Nurs Stud. 2021;118:103911. doi:10.1016/j.ijnurstu.2021.103911