It’s mid-February, and the focus is on love. Love between partners, Gal-entines with friends—and our kids’ love for the copious amounts of candy they got from their classmates!
Self-love is also trending, which is wonderful because you can’t give what you don’t have. In this post, we talk self-love for speech therapists.
But the self-love advice circulating for healthcare workers is limited: The focus tends to be on self-care, which is great, but also on working even harder to somehow will your way to happiness, which is not great at all.
We love the intention behind these resources, but they don’t address two important underlying problems.
The Underlying Problems
1. Our workplaces are structured to burn us out.
Many jobs in health care, including many speech therapy jobs, are literally impossible for a human being to do without breaking down.
Treat 15 patients, present during an unpaid lunch meeting, call up referrals, wait on hold, respond to emails, provide caregiver education, document, maybe have a 2-minute bathroom break…This work schedule is typical—and also totally bonkers!
It’s like driving a car on fumes. The car is guaranteed to break down because it’s not meant to be worked that hard without fuel.
2. We are socialized to accept it.
SLPs are socialized to accept that our employers, professional organizations, and mentors know better, so we must work as hard as possible to fit into their molds.
If this feels bad, we must hide it because it means that something’s wrong with us.
And even when we realize that aspects of our jobs aren’t serving us, we can’t do much more than complain, because it’s just the way things are.
Oh, and since we’re predominantly female, we must smile and be nice always.
That’s why we advocate for a different type of self-love—a fierce self-love—that gets to the root of why so many SLPs are destined to burn out.
And don’t worry: We’ve created a roadmap to help get you there.
Roadmap to Fierce Self-Love
1. You do YOU
AKA, undoing grad school and internships.
The first step in the Roadmap to Fierce Self-Love is learning how to listen to and trust yourself. And this means breaking free of the molds that don’t serve you.
The systems that taught you to become a speech-language pathology professional created their own social structures and cultures to teach (force?) you to fit in their molds.
They often used fear (“Do it or you’ll fail the class”), comparison (“the last intern could see ten patients every day, why can’t you?”), and rigid standards (“this is the protocol ® ™! Any other way can’t work.”)
We know this because we experienced grad school, internships, and multiple jobs.
But we also know this because Chung teaches both undergrad CSD and graduate/doctoral students. The difference between them is shocking. The eager, inspired undergrads become almost universally anxious, more rigid, and exhausted in graduate school.
We’re not here to judge anyone or any institution—everyone is doing the best they can with what they’re given.
But if you can recognize the social structures and cultures around you, you can more easily break free of them.
How to Listen to & Trust Yourself
- Learn to tell the difference between what you were taught is true and what is actually true for you.
- Your preceptor taught you that hospitals have hierarchies that must be followed. Is this true for you?
- The other therapists take pride in pushing unruly patients to bend to their plans. Does that feel good to you?
- The well-known swallowing course says that their way is the only way to treat dysphagia. How does that feel inside?
- Pay attention to how you feel in your body when you do something that’s right for you. Now, how does it feel when you do something that’s wrong for you?
- When you make yourself attend the 3rd lunch meeting this week, how does your body feel? Muscles tense, mind racing, a burning in your stomach?
- When you discharge a patient who sincerely does not want speech therapy, how does your body feel? Lightness, tingly skin, a wide smile?
- Do more of what feels good to you.
- Skip the lunch meeting to enjoy a quiet hour alone. Or FaceTime with your baby at daycare.
- Say “hello” but skip the small talk with the passive-agressive co-worker.
- Decide to listen to your gut more when making decisions with your patients. With less friction, you realize that you get better results!
2. Be Present
You’ve identified what’s right for YOU and taken steps to make choices that align with it. Wonderful!
BUT, HEADS UP! There will absolutely be times when parts of you freak out and revert to old habits.
We are wired to fit in with others, after all. And our jobs—which pay for food, shelter, and healthcare—represent basic survival. It can be terrifying to compromise all of that by breaking out of the mold.
So how can we stay on the path of fierce self-love when our amygdalas are activated and we’re having flashbacks of caregivers telling us to “be a good girl”?
We can be more present.
How to Be Present
Reign in worries of future consequences and memories of the past and hone in on what is happening right now.
Look around. What’s in front of you? To your sides? Behind you? Can you feel your feet grounded on the solid earth? The life in your hands? Can you take just 10 seconds to observe 5 deep breaths? Good.
Now ask yourself this question: What is happening right now?
If you’re with a patient, then be fully present with the interaction you’re having. Listen with your whole being. Speak with intention. Slow down. You’ll get better results (we promise)—and be practicing person-centered care to boot.
What if you don’t like what’s happening right now? Realize that you have 3 choices:
- Change it. If you really can’t change it, then…
- Leave it. If you can’t leave it (yet!), then…
- Accept it.
The 4th option—to fight, worry about, or complain about what’s happening—will just make you suffer.
3. Cut the Crap
You’re doing more of what feels right to you and you have a game plan for when you’re facing what doesn’t feel right. Way to go! With that foundation, the next step is to cut the crap!
Introducing the 80/20 rule. The 80/20 states that 80% of results come from 20% of actions.
Some examples of the 80/20 rule in action (from asana.com):
- 20% of a plant contains 80% of the fruit
- 80% of a company’s profits come from 20% of customers
- 20% of players result in 80% of points scored
What does this mean for speech-language pathology professionals? That 20% of your job duties cause 80% of your stress. Think about it! When I applied the 80/20 rule to my job, this is what I discovered:
- Around 20% of my clients were feeding clients. Despite taking courses and years of experience doing it, I just don’t like or get feeding therapy. So it was causing 80% of my ineffectiveness while treating.
- About 20% of my day is documentation. But my reports took so long (and were chronically late) so documentation was causing 80% of my stress.
How to Cut the Crap
- Make a list of what you do every day for work.
- Circle the 20% of activities that cause 80% of your stress and that take way too much time away from your #1 objective, which is help your patients reach their speech therapy goals.
- Start cutting the crap!
Ask yourself, what can I let go of?
For example, I decided to stop treating feeding patients so I could focus more on the patients I could serve better. I asked the scheduler to not put any feeding patients on my schedule. She looked at me funny (and tried a couple of times to squeeze one in), but each time I calmly reminded her that, no, I was no longer seeing feeding patients. It was an instant boost to my quality of life!
What can you let go of? Committees? Excess work meetings? Doing too much each session?
Ask yourself, what can I add?
During my 80/20 audit, I took the time to create my own documentation templates. Then I invested in a fast new laptop that I always carried with me so that I could document during every session. I also added a rule for myself: I would not leave work until my notes for the day were finished. Suddenly, my weekends and evenings were free for relaxation and time with my family—instead of documenting and/or worrying about late reports.
Congratulations, you’ve cut out so much of what doesn’t serve you—and realized that it actually takes time away from what makes the biggest impact in your job!
Let’s add the next level of fierce self-love. Self-advocacy.
Ask yourself: What do I need?
Are you able to get it on your own? If not, who can you ask to help you get it? Once you identified this person (supervisor, CFY mentor, patient’s caregiver), ask for what you want! Be specific and concrete when you ask. Be willing to compromise, but be firm about your needs.
For example, if your caseload is bonkers, instead of asking your supervisor for “fewer patients,” ask specifically for “a maximum of 12 patients per day, for 30-minute sessions, starting within 2 weeks.” Or whatever makes sense for you and your work setting.
While you can never guarantee the person will respond the way you’d like, here are some tricks to increase your success rate:
- Remain present and calm. Remind yourself that self-advocacy is a fundamental human right.
- Speak with the person when they aren’t busy. This is often late morning or early afternoons on Wednesdays and Thursdays.
- Keep the request about you. Avoid accusations, which tend to make people defensive and less receptive.
- For example, instead of saying, “this patient refuses to work with me,” say, “I am not getting through to this patient, and I believe they would be better served by a different SLP.”
- Or instead of saying, “you’re giving me too many patients,” say, “I’m feeling overwhelmed by my current workload and need it to change.”
- Use “I feel” statements.
- For example, “I am feeling overwhelmed…” “I feel my work suffers when…”
If changing the situation doesn’t work, remember your 2 other options: leave the situation or accept it.
More Self-Advocacy Articles
5. Set those Boundaries
With the calm confidence of a person who knows what they want, it’s time to set boundaries around the parts of your job that continue not to serve you.
How to Set Boundaries
Boundaries will be set inside of yourself and outside of yourself. For example:
- Internal boundary: You determine to finish your notes before leaving work every day.
- External boundary: You ask for a better office space where you can concentrate on documenting.
When setting external boundaries, you will ask specifically for what you want and need.
For example instead of saying, “I can’t focus on documenting,” you’ll state, “The open office doesn’t work for me as I can’t keep up with my documentation without quiet and privacy. Every afternoon, I need a private room to document in for one hour. I’ve made a schedule to reserve the conference room next week, let’s please review it together.”
Here are common areas that may need boundaries:
- Ask for fewer or more patients
- Negotiate productivity
- Understand what is your actual job versus unspoken expectations (i.e. do you really need to join that committee?)
- Set time limits
- Understand when to discharge. Sometimes other providers or disciplines will do a better job with a particular patient. And that’s okay.
- Quit! Seriously. If your workplace will not budge on things that are important to you, you have our permission to quit. We’ve both quit multiple jobs and never regretted it.
Congratulations, you’re practicing fierce self-love!
You started by honestly admitting that our field and the health care system are not set up for therapists’ best interests.
Then you took responsibility for your own needs: You figured out what’s right for you and how to cut the rest.
Finally, you set boundaries to protect your well-being and because you realize that your well-being correlates with better patient outcomes. Not because you give them less, but the exact opposite—you now have the space to show up with the best of your skill and creativity.
Please remember that the keyword here is “practice.” We are bound to trip up or forget to practice fierce self-love. No worries. We have this next moment to try again. And we are right there with you!