WHO CARES For US Opening Paths To A Critical, Collective Notion of Self-Care

WHO CARES FOR US?
Opening Paths to a Critical, Collective Notion of Self-care

Author(s): Norma Jean Profitt
Source: Canadian Social Work Review / Revue canadienne de service social, Vol. 25, No. 2,
International social work / Le service social international Conceptual, Practice, and
Research Issues / Enjeux reliés aux concepts, à la pratique et à la recherche (2008), pp. 147-
168
Published by: Canadian Association for Social Work Education (CASWE)
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WHO CARES FOR US?
Opening Paths to a Critical, Collective

Notion of Self-care
Norma Jean Profitt
Abstract: Interviews with five social workers in San Ramón, Costa Rica, working
in the field of gender and family violence, reveal four themes that they found inte-
gral to self-care: the interrelation between the personal and the professional;
institutional parameters; the ongoing negotiation of boundaries and limits; and
the effects of work with victims of violence. Their experiences point to the need
for a critical, collective notion of self-care to expand the individual notion of
self-care that currently pervades the profession. An expanded notion must rec-
ognize both the life-giving and the wearing effects of our work, as well as the mul-
tiple and diverse processes of consciousness-raising, growth, and struggle in
which social workers engage during the course of their labours.
Abrégé : Quatre thèmes faisant partie intégrante de l'autonomie en matière de

santé se dégagent des entrevues réalisées auprès de cinq travailleurs sociaux de
San Ramón, au Costa Rica, travaillant dans le domaine du genre et de la violence
familiale : Interrelation entre le personnel et le professionnel; les paramètres
institutionnels; la négociation continue des limites; et les effets du travail avec
les victimes de violence. Leurs expériences font valoir la nécessité d'une notion
critique et collective de l'autonomie en matière de santé pour élargir la notion
individuelle correspondante qui prévaut actuellement au sein de la profession.
Cette notion élargie doit reconnaître les effets tant vivifiants qu'épuisants de
notre travail ainsi que les processus multiples et divers de sensibilisation, de
Norma Jean Profitt is associate professor in the Department of Social Work at St. Thomas
University. Costa Rican participants Carmen Cruz Ramirez , Enid Cruz Ramirez , Gret-
tel Elizondo Soto , Margarita Fonseca Murillo , and Maria Ramirez Obregon, as well as
Hannia Franceschi Barranza (professor of social work at the University of Costa Rica) chose
to be recognized as collaborators in this article. The author also acknowledges the contri-
butions of others: the late Brian Ouellette, colleague at St. Thomas University, for many
invigorating discussions about the personal and the professional; Jo Lang, executive direc-
tor for AIDS-New Brunswick; Sue McKenzie-Mohr, colleague; and Gail Taylor. She also
thanks the journals reviewers for their critical, constructive feedback and the Social Sci-
ences and Humanities Research Council for funding this research.
Canadian Social Work Review, Volume 25, Number 2 (2008) / Revue canadienne de
service social, volume 25, numéro 2 (2008)
Printed in Canada / Imprimé au Canada
147
148 Revue canadienne de service social, volume 25, numéro 2
croissance et de combat auxquels les travailleurs sociaux prennent part dans le

cadre de leurs activités.
T HE EXPERIENCE of five social workers in San Ramón, Costa Rica,

working in the area of gender and family violence, offers a broadening
perspective on the issue of self-care. This discussion of self-care grew
out of a study designed to examine the relation between social workers'
processes of personal, professional, and political growth and their social
work practice with individuals and communities. Although feminist and
structural social work has emphasized the role of critical consciousness
in social work practice, the literature has rarely explored how social
workers themselves have experienced conscientization about their per-
sonal and social worlds and how such politicization orients commitments
to social justice. With the goal of understanding these connections, I
interviewed social workers in the county of San Ramón, Costa Rica, and
the district of Fredericton, New Brunswick, who were practising from a
feminist or gender perspective.
Early in the study, participants in San Ramón identified self-care as
an issue of significance and concern. They situated self-care in the con-
text of the sweeping social and economic changes that have taken place
in Costa Rica, especially in the last decade. Neo-liberal policies and the
effects of globalization have enormously increased the impoverishment
of the people, impeding their right to the most basic needs such as food,
shelter, health, and education (Picado Mesén, 2004). These conditions
have fostered a deterioration of the quality and rights of citizenship and
the fundamental fabric of society, generating confusion, desperation,
and frustration (Picado Mesén, 2004). A profound restructuring of social
institutions and programs has occurred, subverting people's faith in the
political system. In the face of worsening social conditions and momen-
tous political decisions affecting public institutions, which include the sign-
ing of a recent "free trade" agreement with the United States (known in
Costa Rica as el Tratado de Libre Comercio ), participants demonstrated an
unswerving compassion and solidarity with the people they served.
Four themes emerged as being integral to the issue of self-care for
Costa Rican participants: the interrelation of the personal and the pro-
fessional; institutional parameters; the ongoing negotiation of boundaries
and limits; and effects of work with persons affected by violence. These
themes raise some considerations in thinking about a more politicized,
collective notion of self-care, as opposed to the individualized notion of
self-care that currendy pervades the profession. Conceptualizations of self-
care must move beyond individualized responses to negative stressors in
the workplace, discomforting emotions, and difficult micro-relations.
An expanded notion must recognize both the life-giving and wearing
effects of our work, as well as the multiple and diverse processes of con-
scientization, growth, and struggle in which social workers engage dur-
Canadian Social Work Review, Volume 25, Number 2 149
ing the course of their labours. Self-care must take into account the
meaning-making activities of social workers as they make sense of their
practice and their personal and social worlds.
Contextual elements:
Self-care in the social work profession
The issue of self-care is often raised in the context of ethical social work
practice (Hesse, 2002; Neumann & Gamble, 1995). Ethical practice
requires that helpers monitor their physical, psychic, and spiritual state
to ensure the provision of competent and adequate service to clients
(Canadian Association of Social Workers, 2005a, 2005b). If psychic dis-
tress, mental health difficulties, or personal problems impede their abil-
ity to do so, then it is incumbent upon them to seek appropriate reme-
dies to prevent jeopardizing the well-being and interests of their clients.
In the helping professions, self-care is considered essential in maintain-
ing positive energy, enhancing capacity for empathy with clients, and
appreciating processes of healing and regeneration (McCann 8c Pearlman,
1990; Neumann 8c Gamble, 1995). Therefore, social workers have an
ethical responsibility to practise self-care, incorporating a series of strate-
gies and activities both at and outside work.
In the past 15 to 20 years, a growing body of mainstream social work
and related literature has specifically addressed vicarious trauma and
strategies for self-care (McCann 8c Pearlman, 1990). This body of writ-
ing and research focuses on the profound effects and changes that some
professionals experience due to empathie engagement with people who
have suffered traumatic experiences (Astin, 1997; Bell, 2003; Cunning-
ham, 2003; Figley, 1995; Hesse, 2002; Pearlman & Maclan, 1995; Pearl-
man 8c Saakvitne,1995; Regehr 8c Cadell, 1999). From a critical social
work perspective, the richness of feminist literature on trauma and vicar-
ious trauma is that it offers a perspective on trauma and the theory of
trauma based in an understanding of social context and recognition of
the strengths of traumatized persons (Burstow, 2003; Gilfus, 1999;
Ramellini Centella 8c Mesa Peluffo, 1997).
Specific effects of repeatedly bearing witness to people affected by vio-
lence and trauma, among them victims of gender and family violence,
war, genocide, and disasters, include intrusive images, the numbing or
flooding of emotions, hypersensitivity to violence, grief, anger, and hope-
lessness. With the passage of time, profound changes can occur in fun-
damental aspects of the self, for example, changes in identity, loss of
the ability to manage intense feelings, and difficulties in preserving a pos-
itive sense of self and relating to others (Carmody, 1997; Dane, 2002;
McCann 8c Pearlman, 1990; Schauben 8c Frazier, 1995). Other signs of
vicarious trauma include distancing oneself socially and permanent
changes in cognitive schémas that encompass the entirety of beliefs,
assumptions, and expectations about oneself and the world that allow one
to find significance in the experience of living, including spirituality
(Dane, 2002).
Exploring the effects on helpers working with abused women, Gillian
Iliffe and Lyndall Steed (2000) found that some counsellors experienced
change in cognitive schémas such as hypersensitivity to violence and to
other manifestations of power, as well as a tendency to see these mani-
festations as an integral part of life, particularly women's lives. While
feminist theories would likely interpret such responses as part and par-
cel of consciousness-raising about social realities, changes in which helpers
can no longer see the world as benevolent or benign can be experienced
as difficult and painful (Burstow, 2003; Camacho, 1995; Campbell, 2002;
Clemans, 2004; Coholic & Blackford, 2003; Gilfiis, 1999).
Self-care could be broadly conceived as strategies intended to care for
the self. However, self-care is predominantly conceptualized in the lit-
erature as individual practices consisting of thoughts and actions that
social workers employ to attend to and deal with internal or external
demands perceived as stressful, draining, intense, or traumatizing. Most
often directed at individuals, strategies are designed to nurture and
strengthen workers, helping them cope with stress, fatigue, and a vari-
ety of emotions. Obviously, helpers' efforts toward self-care will more
likely be fruitful when colleagues, supervisors, the organization or insti-
tution, and community support them with the necessary conditions and
resources.
In contemplating the issue of self-care, we must give

to how the spheres of the personal and the professional a
ized. Generally, mainstream social work literature exhorts
to be conscious of how their values, beliefs, attitudes, and
riences influence practice (Hepworth, Rooney & Larsen, 19
psychoanalytic and family therapy literature examines
fully, an underlying assumption appears to be that it is p
the personal - values, beliefs, life experiences - out of th
equation (Sheppard, 2000). That these realms can and shou
arate often translates into expectations of clear boundaries
and personal life. Frequently in this literature, the goal ap
achievement of a position of objectivity, or at least neutralit
personal does not contaminate professional practice.
In contrast, the critical social work (feminist, structu
progressive, anti-oppressive) literature conceptualize
between the personal and the professional with more com
work is understood as a political endeavour in which the
be separated from the political (Dudziak, 2002). Socia
power clearly permeate and influence all intrapersonal a
sonal phenomena, including interactions between social
clients (Rossiter, 2000). Pärticular attention is paid to bot
relations are reproduced in the professional-client relationship and

how the subjectivity of the social worker is implicated in these dynam-
ics of power.
Critical social work literature speaks to the formation of personal
and professional identities through multiple and multifaceted experi-
ences, including diverse processes of socialization traversed by hierarchies
based on gender and class, among other factors. Thus, to take up the
struggle against injustice in everyday life, social workers must become con-
scious of their formation by dominant and subordinate social construc-
tions (Freire, 1982; Lundy, 2004; Mullaly, 1993, 2002). Personal identity
and professional identity are understood as inseparable and as two sides
of the same coin; both shape professional practice (Fernández Vargas,
2006; Guzmán Stein, 2002; Méndez Vega, 2003). Given the differing
assumptions about the relation between the personal and professional that
underlie mainstream and critical social work perspectives, the implica-
tions of each for thinking about self-care will also vary.
Methodological aspects of the study

Consistent with critical theory, feminist social work theories have empha-
sized the significance of consciousness-raising or conscientization, crit-
ical social analysis, and collective action (Bricker-Jenkins, Hooyman &
Gottlieb, 1991; Dietz, 1999; Dominelli & McLeod, 1989; Mullaly, 1993,
2002; Valentich, 1986; Van Den Bergh, 1995; Van Den Bergh & Cooper,
1986). Transforming consciousness and politicizing everyday practice
are key to contesting oppression and constitute a necessary and signifi-
cant component in socially transformative struggle (Henriques, Holl-
way, Urwin, Venn & Walkerdine, 1984). In this study, feminist theories and
a feminist qualitative approach provided a framework and method for
exploring participants' meaning-making about gender, lived experience,
self-understandings, and processes of conscientization.
In San Ramón, participants were recruited through the Western
Regional Network for the Attention, Prevention, and Erradication of
Family Violence. Of the five social workers who came forward, four worked
in state institutions and one in a non-profit, grassroots women's organ-
ization called Women United in Health and Development. One partic-
ipant who worked for the state also worked half-time, as part of her insti-
tutional commitment, in the same women's organization, which she had
helped found in 1986. In 1987-1990 I had worked as a CUSO cooper-
ant with this colleague in Women United, and her support of my research
was important in recruitment and throughout the study.
Using a semi-structured interview format, I talked with participants
on two separate occasions, each conversation lasting approximately an
hour and a half. Interviews were conducted in Spanish, the primary lan-
guage in Costa Rica. When I returned their second transcripts to them,
I also included a summary of social work literature about conscientiza-

tion and processes of personal, professional, and political growth.
At the request of participants, I organized two popular education
workshops, integrating critical reflection, bodywork, music, and medi-
tation. The first responded to their desire to reflect on the effects of
their work on their personal and professional selves. The second reflected
on and analysed the issue of self-care and themes from the interviews. Fol-
lowing the second workshop, I sent them a summary of themes organ-
ized around their voices. After these workshops, participants from Costa
Rica came to Fredericton for an exchange with New Brunswick partici-
pants, providing a forum in which to share experiences and struggles as
well as strategies for self-care.
As requested by the participants in this exchange, I wrote a report on
self-care, and we presented highlights of this report to the community in
a meeting of approximately 60 social workers, professionals, commu-
nity members, and social work students of the San Ramón campus of the
University of Còsta Rica. One participant took the initiative of circulat-
ing over 100 copies of the report to women's organizations and the
regional networks on family violence throughout the country connected
with the governmental National Institute for Women. Later that week,
we held a workshop on self-care, using bioenergetic theory, for 18 health
care professionals in San Ramón, including research participants, social
workers, psychologists, and community health workers.
Interrelation between the personal and professional

A predominant theme in participants' narratives concerned how the per-
sonal and the professional mutually illuminated each other and led to sig-
nificant growth that expanded and enriched their conceptual framework
and social work practice. Professional practice often sparked reflection
about formation and personal biography and prompted a reinterpreta-
tion of past experience in a critical light. Professional practice served as
a mirror for participants, reflecting the power dynamics in intimate and
familial relations, child-rearing, domestic work, and care arrangements.
Practice provoked critical consciousness about their personal trajectories,
resulting in changes in their intimate lives, interpersonal expectations,
sense of self, and personal and professional identities.
For Ziomara, a social worker in family court, practice with victims and
aggressors of family violence was a catalyst for conscientization. In review-
ing her own history, she clarified the nature of her internal struggle
between what she wanted to be and what she thought she should be.
"Professional practice is a catalyst for conscientization. "

For all the professional training that you have, you come from a typical
family and you have to break down your own worldview, the worldview
of your family. I come from a very traditional family with very established
patriarchal roles and I say: "Well, the same thing happened to me in my
family with me and my brothers," and all that is reflected back to you
because you come from the same environment, from the same mecha-
nism of socialization that is so deeply rooted. Also, the knowledge that
you gain in professional practice helps you, it gives you the option of
changing and modifying your personal and familial life. In what sense?
Well, I am not going to pander so much like my mother with my broth-
ers; I am going to teach my son this and that, the same as with my
daughter, and create equality in the home because you know very well
the consequences of gender inequality and that is very applicable to
our personal life.
Although social work training had provided Ziomara with some theo-
retical elements for analysing gender relations, it did not touch her
deeply in her own life or prepare her for seeing the reflection of her life
in the lives of others. Practice was what provoked a questioning of the
social devaluation of women and generated options for personal and
familial change. As part of this conscientization process, she developed
a theoretical framework of gender to inform her practice.
Practice intersected with personal situations to prompt participants
to confront themselves and apply in their own lives what they espoused
with clients. Maria Elena's personal circumstances underscored her need
for congruency between what she advocated with clients and her own
actions.
"I had to confront myself about what I said in theory to women and what I
assumed in my life as a woman. "
I then had to face in my own intimate relationship how to handle those
things that I had always talked about with women, when I became preg-
nant without having planned it, without having a formal relation which
wasn't my preoccupation at any rate, but yes, when I had all those doubts
about motherhood, when I was concerned about how to handle my rela-
tionship, when I still wasn't prepared for what was happening... when I
was alone, inside I questioned myself: "Am I going to be able to raise a
child on my own? Do I have the capacity as a woman?" And I had always
said to women: "Yes, as women we are capable, we don't need a man
because we have been raised to believe that we are nothing if we don't
have a man," so suddenly I found myself in the same situation and I said
to myself: "Okay, what is this?"
The process of reaffirming in herself what she taught women generated

greater integrity in practice and a richer appreciation of the complexity
of women's struggles to reclaim themselves.
Participants' subjectivity was a valuable resource for sharpening their
understanding of the social processes of gendering in women's lives.
The benefits of their growth extended to and enriched the collectivity of
clients, colleagues, families, and community. Furthermore, their mean-

ing-making informed their sense of professional identity and led to an
integration of their personal and professional selves.
Institutional parameters
The weight of institutional parameters on conscience and actions was a
strongly articulated theme in this study. Although they experienced it in
different ways, participants accentuated their struggle within institu-
tional structures and rules that dictated a methodology of casework and
impeded more liberatory, collective ways of working with people. Their
morale, social ethic, and identity were affected by labouring in institu-
tions that corresponded to an ideology that organized "the problems" of
the people as private, individual matters.
Ana, an employee of 20 years in a state institution intended to pro-
vide financial assistance to the poorest of the poor, had recently begun
to attend to women who were victims of partner violence. She spoke of
her frustration about being prevented from working in ways that were
more in line with her personal and professional values.
"If I do what I believe , they will throw me out. "

There are institutional policies that are what guide the work that we do
and if you go against those policies, they will throw you out; that hap-
pened to me when I began to work here, I came here with a very clear
mentality, very much of struggle, of many things and when I began to
work that was when I had my first experience of resistance. Social work
training teaches you to analyze situations such as those of class struggle
but you can't do anything because you are enclosed within institutional
policies and when you try to do something, things go bad for you; that
happened to me with a population where I believed that people should-
n't be given money, people could be taught how to earn income for
themselves but that wasn't permitted. We tried to promote something dis-
tinct and from there I was subjected to an investigation because that
couldn't be, it was illegal within the framework of the institution although
it was work that promoted social welfare. I was convinced that that was
what social work should be so that people were able to make their own
income; at the end I ended up saying: "If I do what I believe they will
throw me out, I'll be without work, so therefore I will accommodate."
Constrained by the policies and practices of the institution in which she

herself was implicated, Ana named the shame she felt about her role as
provisioner of humiliating and inadequate remedies. Although she
believed that the assistance program kept people from starving, she
found it difficult to reconcile her accommodation to the system.
Another participant, Cristina, worked in the same institution. As a
young woman, she experienced an intense process of conscientization,
coming to see as "truth that the social making of woman is a power strug-
gle." Highly attuned to women's needs, she expressed anger and dis-
gust at the institution that offered only institutionalized solutions to
women's poverty and violence rather than real alternatives.
"What can I do to unburden my conscience ?"

This is a vulgar palliative institution that silences the conscience of poor
people in order to demoralize them socially, never will it ever touch a
hair of structural poverty unless it develops, under the concept of edu-
cation for liberation, projects of real knowledge and understanding at
the grassroots. Meanwhile what I do is earn a salary with a lot of vul-
garity... it's a professional dissatisfaction because one isn't contributing
or learning but rather describing a historical process that is more than
well documented; you only have to go to the bank of the International
Monetary Fund to see what is the range, the index of poverty in Costa
Rica, oh, and then to put faces to it? Rosa, Carolina, it's shameful, it's
a shame but that is what gives me the means to eat and what can I do?
Her feelings of anger, shame, complicity, and devaluation as a professional

were not assuaged by her knowledge of the historical and political dynam-
ics that have shaped state responses to poverty. Burdened by the ethical
conflicts that her role raised, she sought a relation with the people "that
does not violate the Other" (Cornell, 1995, p. 78). The contradiction
between the act of helping and the act of oppressing consumed vital
energy, limiting her professional identity as well as the identities of the
people she served.
Unable to develop the political potential of the people in the ways
they desired, participants moved within institutional parameters, resist-
ing strategically, educating and politicizing others, including other pro-
fessionals, advocating clients' rights, capturing resources for client sup-
port groups and training, and looking for and sometimes finding
alternative spaces in which to foster political potential. For Maria Elena,
who had a long and distinguished history of political activism in social
movements, political struggle in spaces outside the institution was indis-
pensable in countering feelings of frustration and powerlessness and in
fostering congruence between her political-ideological position and her
personal and professional values. Participants' actions served to protest
institutionality and manifest personal and professional values.
Ongoing negotiation of boundaries and limits

A third theme concerned the continuous negotiation of boundaries and
limits between the professional realm and personal space. Participants
worked on a number of fronts to manage internal struggles, contain
emotions and intrusive images, and keep preoccupations about clients and
other pressures from spilling over into the personal domain and family
life. Setting limits around compassion and empathy with clients and
seeking an equilibrium between political struggle and personal time
were ongoing challenges.
In her work with abused women and children at a grassroots women's
organization, Pilar had to find a way to balance her identification with
clients with the need to protect herself from too much hurt. Rooted in
her personal values and religious principles, she related strongly with
women in an egalitarian and humanitarian way.
" Learning to protect one's human sensibility. "

And with my way of working with women I have to be careful because
my relations with them can affect me a lot; at one point in time I did-
n't know how to handle it, therefore I took on a great deal the problems
of others, now I prepare myself emotionally... with the passage of time
I realized that I couldn't continue on like that because I was working a
great deal my compassionate side, the human part of me, the woman part
of me, apart from being who I am, I learned to be very kind, very char-
itable, maybe or that I identify with people's problems, I am very sen-
sitive to what is going on with people, therefore, at the moment when
I am trying to be of some help to them, I go along feeling their concerns
as if they were mine, I go along absorbing them and that part was also
hurting me, or to say it another way, I had to work on that. I said to
myself: "No, this can't be, "...in that moment I can be an instrument
that can help someone but I can't carry their problems, and I don't
deny that yes, there are moments when my human part comes out, it isn't
that one stops being human but that sensitive part, that part that was
hurting me, that part that was identifying with that person, not in a
professional way.
Although social work training had taught Pilar to guard a certain distance
between herself and clients, she had to learn this through experience. Cer-
tainly, it would be difficult, if not impossible/to remain spiritually unaf-
fected by the daily act of witnessing the violence that some human beings
inflict on others. While her formation as a woman, her personal experi-
ence of gender oppression and violence, and her knowledge of social suf-
fering shaped her identification with clients and generated compassion,
she had to establish internal boundaries that would protect her and
enhance her resilience over the long term.
In Maria Elena's case, a clear and explicit political-ideological vision
guided how she lived her life and practised social work. She could not
establish definitive boundaries between the personal and the profes-
sional and live as if her vision could be separated from practice, social
struggle, or her personal life. She fought to maintain a balance between
social commitment and space for a personal life.
" Seeking a balance between engaging in struggle and maintaining a personal

life."
In my particular case, at times my wish to make gains and advance in
what I am involved in is so great that I violate even my own rhythm
until I sacrifice my own needs, so the question is how to establish a bal-
ance between the personal, the professional, and the political that does-
n't absorb you more, how to achieve this equilibrium. What happens is
that I sacrifice the personal, and the personal without a political-ideo-
logical vision, well, for me my personal life has to be assumed under a
political-ideological vision, so then at times what happens is that I give
all my energy to the personal and the professional and political suf-
fer... so for example, when there are spaces for self-care, suddenly I am
justifying the fact that I have so much work that I don't have time for self-
care... because I learned very well the lesson that I have to be doing for
others, but in addition, I learned very well the lesson of always having
to do everything with double the effort in order to demonstrate that
what I am doing is worthy.
For years Maria Elena has extended her "ethical-political" commitment

(Picado Mesén 2004, p. 137) outside the normal work day through her
participation and leadership in women's and popular struggles such as
the recent movement against the free trade agreement with the United
States.1 While most colleagues viewed her involvement simply as a per-
sonal sacrifice, she considered it a manifestation of her vision. Chal-
lenging the carving out of distinct boundaries between the personal,
professional, and political spheres, she attested to the integration of per-
sonal and professional life.
Participants identified strongly with the people they served, partic-
ularly in terms of gender and class oppression. Their identification was
rooted in values and beliefs about social justice and human rights and in
their processes of conscientization that led them consciously to assume
changes in their personal and familial lives. In this way, their critical
consciousness served as a source of strength and motivation for prac-
tice. Given these understandings, the establishment of firm boundaries
and limits between the personal and the professional was not a simple,
static, or easy matter, but rather a much more complex, fluid, and ongo-
ing process of negotiation.
Effects of work with victims of violence
The fourth theme in participant interviews had to do with the effects of

working with gender and family violence. Witnessing pain and suffering
affected workers in a range of ways: they expressed a moral responsibility
to help others to the best of their ability, a desire to come through in peo-
ple's hour of need, a wish to rescue them from their suffering, an identi-
fication with their anguish, a great esteem for them, a weight of existen-
tial suffering in the world, and a fierce commitment to political struggle.

One participant spoke of images of women's violation coming unbidden
into her mind outside the hours of work, precipitating fear and an unend-
ing search for ways to help women escape from their grave situations.
Ziomara experienced a sense of responsibility and impotence when
facing the needs of clients that neither she nor her community could
begin to meet. Her satisfaction with contributing to clients' education and
healing co-existed with feelings of powerlessness.
"It is there that arises impotence and a sense of so much responsibility. "
It is there that impotence arises, isn't that so? Because the expectation,
for as much as one wants to help so many people, one can't, to know
about so many situations and not know what to do; for example, insti-
tutionally the country has resources to attend to women but lacks
resources to which to refer men, so there is a feeling of impotence
because I can't help beyond what I have to offer. I also know that there
are people who need therapy and the organizations and professionals
that provide it charge for it and not all clients have the economic
resources to access it so that those people stop there. So that is where the
impotence arises, and at times the situations I deal with generate cer-
tain feelings, well, a very great sense of responsibility, and an incredible
amount of tension because with violence, I never know in what moment
there will be a violent explosion, and even if it is true that it isn't my fault,
it doesn't stop touching the threads of human sensibility, so in that sense
I think that there is a enormous feeling of responsibility, although indi-
rect, but it is always there.
Ziomara's feelings were magnified by the social devaluation that made

care work invisible in general and the scarce community support for
. addressing gender and family violence. Although this perception was
changing, professionals tended to view this work as marginal and intim-
idating, passing on their responsibility to those women already shoul-
dering the bulk of the work of providing services and pressing for change.
At the insistence of the women's movement, the state and civil society have
recognized gender and family violence as social issues; however, many of
those caring for victims and pushing for social change are women (Bara-
hona Riera, 2001; Berrón, 1995; Carcedo & Sagot, 2002; Escalante Her-
rera, 2001; Instituto Nacional de las Mujeres, 2004).
At times Pilar found that sadness invaded her, making it difficult for
her to maintain a space for her own person. Immersion in the world of
violence against women and children that others did not share created
both a feeling of isolation and a desire to isolate herself.
"It is difficult to let go of the sadness of this place. "

At times it is a chaos for us here, to detach from the experiences that I
live here with this turbulence in society and the person, Pilar, arrives
home, how is the person Pilar? At times it is very difficult for me to let
go of everything, of the sadness of this place... at times my children
come to tell me about some situation to find some solutions and I say:
"Today I don't want to listen to situations," then I close my door and
everything else up because I don't want to see anyone and the same
thing happens, I feel isolated.
Although Pilar valued her ethic of care and care work, she struggled
under the weight of knowing both the plight of individual victims and the
larger picture of systemic and systematic oppression. Her points of ref-
erence eclipsed other windows on the world.
Participants experienced sadness, impotence, responsibility, and
shock in the context of their knowledge of oppression and injustice,
knowledge derived both from others as well as personal experience
While this savoir faire inspired and gave meaning to their labour, these
feelings co-existed with the joy that they expressed at women's disposi-
tion toward change, the solidarity they demonstrated with people, their
gratitude at having the opportunity to contribute to clients' conscious-
ness-raising and healing, and the commitments they made to social
change, whether individual or social.
Discussion
Social workers in this study revealed the extent and depth of their sense-
making activities about practice: they engaged in processes of con-
sciousness-raising ignited by the intersection of the personal and pro-
fessional, grappled with the weight of institutional parameters on their
conscience and actions, continually negotiated boundaries to protect the
self and personal space, and wrestled with the effects of witnessing and
knowing oppression and injustice. Clearly, personal, professional, and
political growth grew from a synthesis of their personal and professional
selves and the meaning they made of both personal biography and pro-
fessional practice.
What generated a need for self-care for participants was not only
stress, fatigue, or vicarious trauma, the end products of difficult work and
workplaces, but the social roots of these end products so evident in their
efforts to understand themselves and their practice in the context of
oppression and injustice. In taking care of ourselves while taking care of
others, we recognize the social nature of making meaning and its effects
on ourselves as social beings.
Common conceptualizations of self-care, for example, in discussions
of vicarious trauma and compassion fatigue, rarely give any weight at al
to the social context of our work, instead using frameworks rooted in the
language of private feelings, psychology, and individual trauma (Sum-
merfield, 1999). Such frameworks individualize the witnessing of social
phenomena such as gender violence, hunger, and poverty and essen-

tially relocate this witnessing to the realm of private injury. However,
"suffering arises from, and is resolved in, a social context, shaped by the
meanings and understandings applied to events" (Summerfield, 1999,
p. 1454). Therefore, self-care and transcendence are not only individual
religious or intra-psychic issues but community, collective ones (Hernán-
dez, 2000).
Without a doubt, we must attend to the effects and impact on helpers
of witnessing violence and cruelty. However, when we experience vicar-
ious trauma, does the ache generated by empathie engagement with
people not also encompass our knowledge about the enormity of social
injustice? Social injustice is central to the production of suffering, and any
discussion of trauma that neglects "the social origins of pain and suf-
fering" serves to maintain social inequalities (Pedersen, 2002, p. 186). For
some counsellors of victims of violence and trauma, the most difficult part
of their work was not vicarious trauma arising from empathie engagement
with clients, but rather efforts to confront institutional systems that
respond inadequately to people's needs (Schauben & Frazier, 1995).
The frames that we use to understand and analyse self-care shape the
strategies for addressing it. Although they speak tangentially about self-
care, two studies illustrate the import of interpretive frames. In her study
about how Colombian human rights activists made sense of political per-
secution in their lives, Pilar Hernández (2000) found that they inter-
preted their responses within their socio-political framework. Drawing on
moral and social norms and political understandings to make sense of
their situations, they identified resilience, hope, and solidarity as fun-
damental in understanding persecution and trauma in the midst of social
and political turmoil. Political beliefs and ideologies that promote social
justice and peace and interpret violence from a political perspective give
meaning to activism by framing pain and loss in the context of commu-
nity, care, and advocacy for others (Hernández, 2002). In a similar vein,
therapists working with victims of political repression in Chile reported
that their sense of social responsibility and moral commitment sustained
them and helped them contain their horror, terror, and helplessness,
enabling them to channel their feelings by making meaning out of suf-
fering (Comas Diaz 8c Pädilla, 1990).
Participants' efforts to understand their practice and their personal
and professional selves also showed that, over time, processes of consci-
entization, growth, and struggle are dynamic rather than static and
shaped by many factors such as political climate, workplace, world view,
engagement with particular client groups, maturation, and personal
biography and circumstances. For example, as various studies have shown,
political action can help counter vicarious trauma and feelings of frus-
tration, anger, powerlessness, and impotence in working with victims of
violence (Briere, 1996; Clemans, 2004; Coholic & Blackford, 2003;
Comas-Diaz & Padilla, 1990; Dane, 2000; Hesse, 2002; Iliffe & Steed,
2000; McCann & Pearlman, 1990; Schauben & Frazier, 1995). For some
rape crisis workers, activism "emerged as a salve against cynicism" (Cle-
mans, 2004, p. 156). Yet, while activism can serve as a form of self-care
as well as a manifestation of ethical-political commitments, social work-
ers may at some point experience exhaustion and disillusionment at the
slowness of change.
In this regard, a critical, collective approach to self-care is essential
in socializing and analysing both the life-giving and wearing effects of our
work as well as our struggles to make meaning. Certainly, in feminist
and women's organizations addressing issues of abuse and sexual assault,
workers have found that sharing in community, engaging in critical social
analysis, and being sustained within a network of like-minded people
have been essential for carrying on the struggle (Camacho, 1995; Carcedo
Cabañas & Molina Subiros, 2001; Clemans, 2004; Coholic & Blackford,
2003; Facio, 1995). This kind of collective self-care would help us with
what is perhaps the major challenge of social justice and social change
work: the balancing of our knowledge of social suffering with faith and
engagement in the world to make a difference through our helping rela-
tionships and actions for social change. Such care would help us remain
connected to our compassion - not "a perspectiveless cofeeling" but an
informed passion that leads to outrage, solidarity, and political action for
confronting injustice and oppression (Spelman, 1997, p. 85).
For participants, the act of seeking this balance was ongoing. Their
strong identification with the people around gender and class oppression
raises the question of whether and how such identification influences
boundary-setting to protect the self from the blows inflicted by an unjust
social world. The identification that engenders compassion and fuels
our work for justice may generate soul weariness in the face of ongoing
suffering and the slowness of social change. While critical analysis may
foster intellectual understanding and help to contain powerful emo-
tions, it may not do enough to assuage pervasive feelings such as deep
sadness. In this dynamic, images of violence and brutality may also come
to symbolize all that is painful about an unjust world. While sorting out
internal boundaries as an act of self-care and survival can protect helpers,
without a mentor or group of trustworthy colleagues, how do workers pro-
tect their human sensibility and navigate these frontiers, which can man-
ifest in subtle and complex ways?
Related to boundary-setting and self-care is the issue of gender and
how it shapes our lives. When participants ended their work day, their
care work continued into the evening with families, relatives, friends,
and neighbours, a phenomenon documented by female social workers in
Costa Rica (Guzmán Stein, 1994, 2002, 2004; Fernández Vargas, 2006).
Furthermore, as citizens, social workers are subject to gender inequities
in social services and social security for women (Guzmán Stein, 2003).
Their work with women clients inevitably brought them face to face
with issues of gender related to those that they themselves experienced
in their institutions and day-to-day personal and professional lives. As
emphasized by attendees at the community presentation of the report
on self-care, the gendered nature of the profession, gender identity, and
gendered roles in the family and community constrained material con-
ditions and opportunities for self-care. In light of the emotions that usu-
ally accompany the imperative to care for others, as noted by Maria
Elena, ambivalence about worthiness - whether or not female social
workers feel they deserve to be cared for - merits further collective
consideration.
Finally, with respect to self-care, participants raised the issue of past
or present personal experience of oppression and violence. As many
practitioners and helpers have pointed out, personal experience can be
a valuable source of professional knowledge for understanding clients and
their strengths as well as their troubles (Burstow, 2003; Camacho, 1995;
Gilfiis, 1999; Shepherd, 2000). Women survivors of gender violence and
abuse have been instrumental in facilitating support groups for women
on a large scale in Costa Rica (Carcedo Cabañas & Molina Subirós, 2001).
While sensitivity, compassion, passion for justice, and intolerance of
inequalities are positive consequences of experiences of oppression and
violence (Burstow, 2003; Calvo, 1995; Dietz, 1999; Facio, 1995; Gilfiis,
1999; Spelman, 1997), some studies suggest that professionals who are
also survivors of violence and trauma are more vicariously traumatized.
However, to date the evidence for this suggestion is inconclusive (Nelson-
Gardell & Harris, 2003; Neumann 8c Gamble, 1995; Fearlman 8c Maclan,
1995; Schauben 8c Frazier, 1995), and some studies have found that the
resolution of experiences of violence and trauma converts them into
strengths and meaning for practice (Bell, 2003; Pearlman 8c Maclan,
1995).
A critical, collective approach to self-care could support workers in
their process of sorting out how personal experience in general, and
oppression and violence in particular, affect practice as well as the abil-
ity to care for the self. Rather than creating artificial dichotomies between
"normal" social workers with no history of personal experience of oppres-
sion or violence and "victims/survivors" of such experience (Gilfiis, 1999;
Mullender 8c Hague, 2005), self-care could also encompass our processes
of conscientization around our privilege and studied ignorance (Mcln-
tyre, 2000) and the accommodations that we ourselves have made to
survive social relations of domination and oppression. Surely, both of
these sets of dynamics also affect service to clients, including our role as
educators for critical consciousness (Camacho, 1995; Fernández Vargas,
2006). As one participant concluded, "social workers live their own his-
tories in practice."
Recommendations for a more politicized, collective notion of

self-care
If self-care is an important issue to social workers, why have we not

addressed it more effectively? Likely there are several reasons. In today's
climate of neo-liberalism, globalization, and endless assaults on the pub-
lic good, social workers scramble to keep up to an ever-increasing social
need. In the stack of priorities and demands, self-care likely falls to the
bottom. However, I suspect that some assumptions we make about the per-
sonal and the professional impede discussions of self-care. Notions about
objectivity and neutrality, ignorance about just how we bring personal val-
ues and experience into practice, and concerns about colleagues attribut-
ing all aspects of practice to personal biography make such talk dan-
gerous (Profitt, 2002). Moreover, assumptions in mainstream social work
discourse about setting boundaries intimate that a personal or social
commitment to social justice and social change can be separated from pro-
fessional practice and the living of personal life.
Notwithstanding, since Costa Rican participants saw self-care as
embracing their integrity as human beings, they asked what collective
spaces and conditions could exist in or outside the workplace for criti-
cal, collective self-care. They recommended several avenues for action.
First, spaces at work designed to facilitate growth and self-care would
provide a place to reflect, clear the mind and emotions, and recharge
energies. Activities could consist of sharing personal-professional strug-
gles, giving mutual feedback on practice experiences, taking stock of
how one is doing, and collective problem-solving around such things as
organizational and workplace barriers that contribute to isolation and
stress. Ideas for education, training, and self-training would emerge
according to the needs of participants.
Secondly, participants identified the need for collective spaces in
which to reflect on how current or unresolved situations or processes -
"knots" at which we are stuck - impinge on our capacity to help others.
How is it possible to achieve a change of attitude and behaviour in oth-
ers if one cannot achieve it in oneself? Collective reflection could assist
in learning from others' processes of maturation, confronting situations,
and breaking through fears to advance in our practice. Working through
such knots could also contribute to preventing burnout.
Thirdly, social workers recognized the need for a space in which to
continue to build and maintain critical analyses and political practice. As
a concrete way to continue growing and maintaining a critical practice, this
space could serve in a variety of ways: to support those seeking to resist
workplace absorption and generate alternatives to institutional social work;
to assess social workers' situations to establish and clarify strategic alliances
for change; to build credibility among social workers in a particular area
or community; and to reinforce social movements and popular demands
for human rights and social policy that meet people's needs. Issues of how
to resist strategically and facilitate change could be examined more broadly.
In terms of implications for education, participants suggested that
academic professional training should include a course or substantial
elements on the personal biography and everyday experience of social
workers, touching on themes such as how we analyse ourselves as subjects
of social realities, not excluding ourselves in this analysis by always focus-
ing on helping the Other. Academic training should treat in more depth
the contradictions and challenges that exist in professional practice
between theories and the potential of putting them into practice.
In this study, participants proposed a notion of self-care that inte-
grates multiple aspects of social workers' selves in the context of the
richness and complexity of social work practice. Self-care is a practice
designed to ensure quality service to clients and also a practice directed
at the well-being and interconnectedness of social workers with their
communities and struggles for social justice.
NOTE
1 Politics is "understood as on the side of social justice, equity, the universality of a

to goods and services, the consolidation of citizenship, and the guarantee of c
political, and social rights" (Picado Mesén, 2004, p. 137).
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WHO CARES For US Opening Paths To A Critical, Collective Notion of Self-Care

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WHO CARES FOR US?

Opening Paths to a Critical, Collective Notion of Self-care

Opening Paths to a Critical, Collective

Norma Jean Profitt

Abrégé : Quatre thèmes faisant partie intégrante de l'autonomie en matière de

croissance et de combat auxquels les travailleurs sociaux prennent part dans le

T HE EXPERIENCE of five social workers in San Ramón, Costa Rica,

In contemplating the issue of self-care, we must give

relations are reproduced in the professional-client relationship and

Methodological aspects of the study

I also included a summary of social work literature about conscientiza-

Interrelation between the personal and professional

"Professional practice is a catalyst for conscientization. "

The process of reaffirming in herself what she taught women generated

clients, colleagues, families, and community. Furthermore, their mean-

"If I do what I believe , they will throw me out. "

Constrained by the policies and practices of the institution in which she

"What can I do to unburden my conscience ?"

Her feelings of anger, shame, complicity, and devaluation as a professional

Ongoing negotiation of boundaries and limits

" Learning to protect one's human sensibility. "

" Seeking a balance between engaging in struggle and maintaining a personal

For years Maria Elena has extended her "ethical-political" commitment

Effects of work with victims of violence

The fourth theme in participant interviews had to do with the effects of

tial suffering in the world, and a fierce commitment to political struggle.

Ziomara's feelings were magnified by the social devaluation that made

"It is difficult to let go of the sadness of this place. "

phenomena such as gender violence, hunger, and poverty and essen-

Recommendations for a more politicized, collective notion of

If self-care is an important issue to social workers, why have we not

1 Politics is "understood as on the side of social justice, equity, the universality of a

Astin, M. (1997). "Traumatic Therapy: How Helping Rape Victims Affe

Campbell, R. (2002). Emotionally Involved: The Impact of Researching Rape. New

Comas-Díaz, L., & A. M. Padilla (1990). "Countertransference in Working with

Dietz, C. A. (1999, winter). "Coming Full Circle: A Social Worker's Journey

Dudziak, S. (2002). "Educating for Social Justice: Challenges and Openings at

Méndez Vega, N. (2003). "La atención a mujeres víctimas de violencia intrafamiliar

Summerfield, D. (1999). "A Critique of Seven Assumptions behind Psychologi-

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