illustration of people at a desk

Self-Care in the In-Between

As I stare at the empty couch sitting in my office, I cannot help but recall the hundreds of individuals, couples, and families who have collapsed onto it and cried. They cried because they had received information that changed their lives and did not yet know how, or if, their new state of being would ever end. My clients were navigating the in-between. Many individuals pursue therapy due to their in-between situations. Whether they are struggling to cope within it, or attempting to find an end to it, the fact is that living in the in-between can cause an overwhelming amount of distress. I would know—I see it every single day.

Many students preparing to enter the field of therapy ask about the hardest cases I have treated. Since I have answered the question so many times, my response is rehearsed: (1) watching a young mother die in a hospital after ending her life, and sitting with her family at her bedside as they said good-bye; (2) informing parents their teenager had been sexually abused by a sibling; and (3) helping a grandparent cope with the loss of their one-year-old grandchild, who was killed by my client’s child. In response to my answers, students’ jaws tend to drop, their eyes get bigger, and they always ask the follow-up question: “How do you do it? How do you sit with people in these awful times?”

God has called me, as a mental health clinician, to come alongside people in their in-between situations. What I did not realize when answering this call was that I was entering a life of being permanently in between. Some clients are with me for a few months, other clients are with me for several years. By becoming a therapist, I chose to never have a life outside of the in-betweens, probably until I retire. It wasn’t until five years into treating clients that I began asking myself the questions everyone else kept asking: “How do I do this work? How can I continue doing this?” If I wasn’t careful, I would quickly burn out and not be able to fulfill my calling.

My self-care journey began because the three situations mentioned above happened within a period of three weeks, causing me to experience secondary traumatic stress. It was also during this time that I was completing my doctorate and starting a faculty position in Fuller’s Marriage and Family Therapy program. My first career outside of graduate school was beginning, but I was exhausted from the horrific situations I witnessed and questioning how God could help me endure a life of in-between.

The Oxford English Dictionary defines self-care as “the practice of taking action to preserve or improve one’s own health.” Unfortunately, Western society lauds exhaustion and being overworked as status symbols that only the strong-willed can achieve. Such cultural beliefs imply that those who engage in self-care are weak, selfish, or unaccomplished. Fortunately, God provided a wonderful example of self-care in Genesis 2 when he rested (v. 2–3). God didn’t practice rest because he needed it; God rested because he knew we needed it. I think God was preparing us for the challenging in-betweens we were going to face while on earth.

Although the idea of self-care is not a new concept, many people are unaware of which activities constitute self-care and the numerous ways we can practice rest. You will know you have engaged in a self-care activity when you feel replenished and rejuvenated afterward. For example, cleaning and organizing can be one person’s self-care while a run or a bicycle ride can revitalize another. If, after engaging in an activity, you feel guilty or irritated with yourself, it likely wasn’t self-care. For example, watching an extra few hours of television past your bedtime may cause feelings of regret and exhaustion the next morning (not that I’m speaking from personal experience!). There are four areas of self-care that should be tended to: emotional, physical, psychological, and spiritual.

Emotional Self-Care

Emotional self-care is the care of your heart and soul, and one of the most challenging areas of self-care for people to practice. Feelings and emotions can be uncomfortable and vulnerable to experience, which can cause individuals to numb or suppress them. Unfortunately, you cannot choose which emotions you block off. On the other hand, people often report experiencing too much of an emotion and the inability to self-soothe. Regardless of either situation, there are important steps to practicing emotional self-care:

  1. Practice identifying how you feel. Take 5 to 10 minutes a day and notice the emotions you are experiencing.
  2. Once you have recognized the emotion(s), try to identify why you are feeling this way. What thoughts or events occurred that may be contributing to these emotions?
  3. Next, recognize where you feel the emotions in your body. Different emotions can cause different sensations. For example, when I experience fear, my chest tightens and I feel it in the pit of my stomach.
  4. Now here comes the uncomfortable part: sit with the emotions. Don’t run, don’t distract yourself, and don’t dismiss your experience. While sitting with them, identify whether you can change anything about the situation causing the emotions. Many times, in-between experiences cause an immense amount of distress because we cannot change the situation.
  5. If you cannot change the situation, it may be time to reach out for emotional support. Connect with friends, family members, or a pastor, as well as God. Make sure those you reach out to are not people who dismiss your emotions or tell you, “it’s not that big of a deal” or “other people have it worse.”
  6. Finally, if the situation cannot change, what you are focusing on can. If you focus on the in-betweens in your life, your fear and anxiety increase, but if you focus on God, your faith tends to grow.

Validating emotional experiences can be very challenging for people because we think, “it could be worse” or “God won’t give me more than I can handle.” When untrue and potentially damaging thoughts arise, I recommend sitting and reflecting on John 11:35, “Jesus wept.” If the Son of God is experiencing pain, heartache, and sorrow, do you believe he would want you masking yours? When you need to weep, weep. When you need to rejoice, rejoice. Whatever emotion you are experiencing, remember that God is experiencing it with you.

Physical Self-Care

God did not design the human body to last forever. He did design it so people must intentionally take care of it. Physical self-care is checking in with your body and identifying if something needs to change. From the food you consume to fuel your body to the exercise you perform to maintain physical strength, every aspect should be tended to. When life becomes overwhelming and hectic, fast food, lack of sleep, and sitting in front of a computer can quickly become our defaults. To begin recognizing what God and your body are telling you, I recommend weekly body scans, which can look like following these steps:

  1. Find a quiet place where you can lean back and put your feet up.
  2. Take several deep breaths and recognize any tension you have in your body. Intentionally release the tension by dropping your shoulders, unclenching your jaw, and relaxing all of your muscles.
  3. Starting from your toes, notice each part of your body. Is it in pain or discomfort? Is this a new sensation or old one? (Note: If anything is causing you concern, it may be time to head to your medical provider for a checkup.)
  4. Specifically recognize where you hold your stress and any uncomfortable emotions. As you take a few more deep breaths, focus on releasing the emotion or stress from your body.

In addition to body scans, most medical professionals recommend at least 30 minutes of physical activity a day and ensuring you drink at least half of your body weight in fluid ounces of water each day. Additionally, spending time outdoors can provide you with physical health benefits, such as vitamin D. The final aspect of physical health often skipped is sleep and rest, which are necessary in order to engage in the other forms of self-care, so don’t skip this category. Scripture states that our bodies are the temple of the Holy Spirit (1 Cor 6:19). We cannot do God’s work if our bodies are not cared for.

Psychological Self-Care

Similar to emotional self-care, psychological self-care focuses on the minds of individuals. Monitoring your thoughts is one of the most beneficial forms of self-care because what you think about will influence your emotions and behaviors, and vice versa. Unfortunately, we often go about our days with negative, untrue, or harmful thoughts about ourselves, others, and the world. To begin refocusing your thoughts on what Philippians 4:8 tells us to focus on, we must break current negative thought patterns with the following steps:

  1. Find a peaceful place where your mind can wander.
  2. For a few moments, begin to notice the thoughts coming to your mind and write them down. Sit for about two to three minutes, writing down all of the thoughts coming to you.
  3. Reflect on those thoughts. Specifically, identify if the thoughts are true, lovely, commendable, and just (Phil 4:8). It is important to notice if the thoughts are helpful to you and your relationship with God.
  4. If you have identified any negative thoughts, imagine placing them into a bubble and blowing them away. It may sound simple, but it can help to redirect your thoughts.
  5. After blowing away the negative thoughts, write down new thoughts to replace the old ones. The Holy Spirit can guide this exercise and help you to refocus on God.

Humans are consumers, and we must be cautious about the information we consume and how it affects our thoughts. Are you learning about elected officials’ policies and how they will impact your life? Or are you learning about God’s mercy, grace, and love for you? Colossians 3:2 tells us to set our minds on things that are above, not things on earth. I find this action to be incredibly challenging because we can tangibly experience and see the earthly things. But our thoughts can be refocused on God’s kingdom when we engage in psychological self-care.

Spiritual Self-Care

The final area of self-care is spiritual. We can quickly become spiritually depleted when we are stuck in the in-betweens of life. Connecting with God on a regular basis is crucial for the development and growth of Christians. Unfortunately, the negative events of the world can cause many to feel like God has abandoned them, and when they reach out for help, they may receive common responses such as “God has a plan,” and “if you really believed in God, you wouldn’t be so upset.” When I was a student taking the Practices of Vocational Formation course with professor John Bangs, I wrote a prayer of lament focused on one of the in-betweens I was facing. Since then, I have noticed an immediate change in peers and clients who are able to engage in the spiritual practice of lament during their challenging times. The features of lament include:

  1. First, address God by naming his attributes and his relation to you, recalling his previous promises or actions on your behalf.
  2. Humbly state a complaint that describes your suffering.
  3. Confess trust in God and state a specific petition (i.e., heal me, help me).
  4. End the prayer with an expression of hope, confidence, and trust that God has heard you and will answer you.

In addition to the spiritual practice of lament, self-care can consist of attending Bible studies, listening to worship music, and serving God and his kingdom through specific actions. One verse I repeat to myself when struggling and feeling alone is Matthew 27:46, “My God, my God, why have you forsaken me?” This saying of Jesus on the cross demonstrates how our savior struggled to see God in this time of heartache and pain, but he knew God was holy and with him on the cross.

Conclusion

The past decade of my life has been spent learning how to sit with others during life’s in-betweens. I have witnessed the pain of loss, abandonment, murder, rape, suicide, and hopelessness due to the sin in this world. God, in his amazing wisdom and power, knew we needed help during these difficult times. Self-care in these four areas can help sustain us through the in-between challenges and help us to refocus on God and his perfect glory. When we focus on the in-betweens, fear will grow. When we focus on God, faith will grow.

Written By

Brie Turns serves as assistant professor of marriage and family therapy at the Fuller Arizona campus. Her clinical and research specialization centers on families raising a child with an autism spectrum disorder (ASD). She has published numerous scholarly articles and book chapters focusing on individuals and families living with ASD, and she recently coedited Systemically Treating Autism: A Clinician’s Guide for Empowering Families, the first textbook that educates clinicians on the use of systemic models with families raising a child with ASD. Her doctoral dissertation received funding from Texas Tech University and the Solution-Focused Brief Family Therapy Association, and won the 2018 Dissertation of the Year Award from the AAMFT Foundation. She is a Licensed Marriage and Family Therapy Associate in Indiana, Texas, and Arizona.

As I stare at the empty couch sitting in my office, I cannot help but recall the hundreds of individuals, couples, and families who have collapsed onto it and cried. They cried because they had received information that changed their lives and did not yet know how, or if, their new state of being would ever end. My clients were navigating the in-between. Many individuals pursue therapy due to their in-between situations. Whether they are struggling to cope within it, or attempting to find an end to it, the fact is that living in the in-between can cause an overwhelming amount of distress. I would know—I see it every single day.

Many students preparing to enter the field of therapy ask about the hardest cases I have treated. Since I have answered the question so many times, my response is rehearsed: (1) watching a young mother die in a hospital after ending her life, and sitting with her family at her bedside as they said good-bye; (2) informing parents their teenager had been sexually abused by a sibling; and (3) helping a grandparent cope with the loss of their one-year-old grandchild, who was killed by my client’s child. In response to my answers, students’ jaws tend to drop, their eyes get bigger, and they always ask the follow-up question: “How do you do it? How do you sit with people in these awful times?”

God has called me, as a mental health clinician, to come alongside people in their in-between situations. What I did not realize when answering this call was that I was entering a life of being permanently in between. Some clients are with me for a few months, other clients are with me for several years. By becoming a therapist, I chose to never have a life outside of the in-betweens, probably until I retire. It wasn’t until five years into treating clients that I began asking myself the questions everyone else kept asking: “How do I do this work? How can I continue doing this?” If I wasn’t careful, I would quickly burn out and not be able to fulfill my calling.

My self-care journey began because the three situations mentioned above happened within a period of three weeks, causing me to experience secondary traumatic stress. It was also during this time that I was completing my doctorate and starting a faculty position in Fuller’s Marriage and Family Therapy program. My first career outside of graduate school was beginning, but I was exhausted from the horrific situations I witnessed and questioning how God could help me endure a life of in-between.

The Oxford English Dictionary defines self-care as “the practice of taking action to preserve or improve one’s own health.” Unfortunately, Western society lauds exhaustion and being overworked as status symbols that only the strong-willed can achieve. Such cultural beliefs imply that those who engage in self-care are weak, selfish, or unaccomplished. Fortunately, God provided a wonderful example of self-care in Genesis 2 when he rested (v. 2–3). God didn’t practice rest because he needed it; God rested because he knew we needed it. I think God was preparing us for the challenging in-betweens we were going to face while on earth.

Although the idea of self-care is not a new concept, many people are unaware of which activities constitute self-care and the numerous ways we can practice rest. You will know you have engaged in a self-care activity when you feel replenished and rejuvenated afterward. For example, cleaning and organizing can be one person’s self-care while a run or a bicycle ride can revitalize another. If, after engaging in an activity, you feel guilty or irritated with yourself, it likely wasn’t self-care. For example, watching an extra few hours of television past your bedtime may cause feelings of regret and exhaustion the next morning (not that I’m speaking from personal experience!). There are four areas of self-care that should be tended to: emotional, physical, psychological, and spiritual.

Emotional Self-Care

Emotional self-care is the care of your heart and soul, and one of the most challenging areas of self-care for people to practice. Feelings and emotions can be uncomfortable and vulnerable to experience, which can cause individuals to numb or suppress them. Unfortunately, you cannot choose which emotions you block off. On the other hand, people often report experiencing too much of an emotion and the inability to self-soothe. Regardless of either situation, there are important steps to practicing emotional self-care:

  1. Practice identifying how you feel. Take 5 to 10 minutes a day and notice the emotions you are experiencing.
  2. Once you have recognized the emotion(s), try to identify why you are feeling this way. What thoughts or events occurred that may be contributing to these emotions?
  3. Next, recognize where you feel the emotions in your body. Different emotions can cause different sensations. For example, when I experience fear, my chest tightens and I feel it in the pit of my stomach.
  4. Now here comes the uncomfortable part: sit with the emotions. Don’t run, don’t distract yourself, and don’t dismiss your experience. While sitting with them, identify whether you can change anything about the situation causing the emotions. Many times, in-between experiences cause an immense amount of distress because we cannot change the situation.
  5. If you cannot change the situation, it may be time to reach out for emotional support. Connect with friends, family members, or a pastor, as well as God. Make sure those you reach out to are not people who dismiss your emotions or tell you, “it’s not that big of a deal” or “other people have it worse.”
  6. Finally, if the situation cannot change, what you are focusing on can. If you focus on the in-betweens in your life, your fear and anxiety increase, but if you focus on God, your faith tends to grow.

Validating emotional experiences can be very challenging for people because we think, “it could be worse” or “God won’t give me more than I can handle.” When untrue and potentially damaging thoughts arise, I recommend sitting and reflecting on John 11:35, “Jesus wept.” If the Son of God is experiencing pain, heartache, and sorrow, do you believe he would want you masking yours? When you need to weep, weep. When you need to rejoice, rejoice. Whatever emotion you are experiencing, remember that God is experiencing it with you.

Physical Self-Care

God did not design the human body to last forever. He did design it so people must intentionally take care of it. Physical self-care is checking in with your body and identifying if something needs to change. From the food you consume to fuel your body to the exercise you perform to maintain physical strength, every aspect should be tended to. When life becomes overwhelming and hectic, fast food, lack of sleep, and sitting in front of a computer can quickly become our defaults. To begin recognizing what God and your body are telling you, I recommend weekly body scans, which can look like following these steps:

  1. Find a quiet place where you can lean back and put your feet up.
  2. Take several deep breaths and recognize any tension you have in your body. Intentionally release the tension by dropping your shoulders, unclenching your jaw, and relaxing all of your muscles.
  3. Starting from your toes, notice each part of your body. Is it in pain or discomfort? Is this a new sensation or old one? (Note: If anything is causing you concern, it may be time to head to your medical provider for a checkup.)
  4. Specifically recognize where you hold your stress and any uncomfortable emotions. As you take a few more deep breaths, focus on releasing the emotion or stress from your body.

In addition to body scans, most medical professionals recommend at least 30 minutes of physical activity a day and ensuring you drink at least half of your body weight in fluid ounces of water each day. Additionally, spending time outdoors can provide you with physical health benefits, such as vitamin D. The final aspect of physical health often skipped is sleep and rest, which are necessary in order to engage in the other forms of self-care, so don’t skip this category. Scripture states that our bodies are the temple of the Holy Spirit (1 Cor 6:19). We cannot do God’s work if our bodies are not cared for.

Psychological Self-Care

Similar to emotional self-care, psychological self-care focuses on the minds of individuals. Monitoring your thoughts is one of the most beneficial forms of self-care because what you think about will influence your emotions and behaviors, and vice versa. Unfortunately, we often go about our days with negative, untrue, or harmful thoughts about ourselves, others, and the world. To begin refocusing your thoughts on what Philippians 4:8 tells us to focus on, we must break current negative thought patterns with the following steps:

  1. Find a peaceful place where your mind can wander.
  2. For a few moments, begin to notice the thoughts coming to your mind and write them down. Sit for about two to three minutes, writing down all of the thoughts coming to you.
  3. Reflect on those thoughts. Specifically, identify if the thoughts are true, lovely, commendable, and just (Phil 4:8). It is important to notice if the thoughts are helpful to you and your relationship with God.
  4. If you have identified any negative thoughts, imagine placing them into a bubble and blowing them away. It may sound simple, but it can help to redirect your thoughts.
  5. After blowing away the negative thoughts, write down new thoughts to replace the old ones. The Holy Spirit can guide this exercise and help you to refocus on God.

Humans are consumers, and we must be cautious about the information we consume and how it affects our thoughts. Are you learning about elected officials’ policies and how they will impact your life? Or are you learning about God’s mercy, grace, and love for you? Colossians 3:2 tells us to set our minds on things that are above, not things on earth. I find this action to be incredibly challenging because we can tangibly experience and see the earthly things. But our thoughts can be refocused on God’s kingdom when we engage in psychological self-care.

Spiritual Self-Care

The final area of self-care is spiritual. We can quickly become spiritually depleted when we are stuck in the in-betweens of life. Connecting with God on a regular basis is crucial for the development and growth of Christians. Unfortunately, the negative events of the world can cause many to feel like God has abandoned them, and when they reach out for help, they may receive common responses such as “God has a plan,” and “if you really believed in God, you wouldn’t be so upset.” When I was a student taking the Practices of Vocational Formation course with professor John Bangs, I wrote a prayer of lament focused on one of the in-betweens I was facing. Since then, I have noticed an immediate change in peers and clients who are able to engage in the spiritual practice of lament during their challenging times. The features of lament include:

  1. First, address God by naming his attributes and his relation to you, recalling his previous promises or actions on your behalf.
  2. Humbly state a complaint that describes your suffering.
  3. Confess trust in God and state a specific petition (i.e., heal me, help me).
  4. End the prayer with an expression of hope, confidence, and trust that God has heard you and will answer you.

In addition to the spiritual practice of lament, self-care can consist of attending Bible studies, listening to worship music, and serving God and his kingdom through specific actions. One verse I repeat to myself when struggling and feeling alone is Matthew 27:46, “My God, my God, why have you forsaken me?” This saying of Jesus on the cross demonstrates how our savior struggled to see God in this time of heartache and pain, but he knew God was holy and with him on the cross.

Conclusion

The past decade of my life has been spent learning how to sit with others during life’s in-betweens. I have witnessed the pain of loss, abandonment, murder, rape, suicide, and hopelessness due to the sin in this world. God, in his amazing wisdom and power, knew we needed help during these difficult times. Self-care in these four areas can help sustain us through the in-between challenges and help us to refocus on God and his perfect glory. When we focus on the in-betweens, fear will grow. When we focus on God, faith will grow.

Brie Turns

Brie Turns serves as assistant professor of marriage and family therapy at the Fuller Arizona campus. Her clinical and research specialization centers on families raising a child with an autism spectrum disorder (ASD). She has published numerous scholarly articles and book chapters focusing on individuals and families living with ASD, and she recently coedited Systemically Treating Autism: A Clinician’s Guide for Empowering Families, the first textbook that educates clinicians on the use of systemic models with families raising a child with ASD. Her doctoral dissertation received funding from Texas Tech University and the Solution-Focused Brief Family Therapy Association, and won the 2018 Dissertation of the Year Award from the AAMFT Foundation. She is a Licensed Marriage and Family Therapy Associate in Indiana, Texas, and Arizona.

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