You Can’t Pour From An Empty Cup: Permission to Take Care of Ourselves

As Mental Health Awareness Week comes to a close Dr Katya Miles, occupational health doctor, reflects on the importance of permission to take care of ourselves

Permission to Take Care of Ourselves

The Importance of Permission

This year, the theme for Mental Health Awareness Week is Kindness. So there is no better time to talk about permission to be kind to ourselves. 

I return to permission again and again. It is crucial for me personally (I have had anxiety and burnout) and for all us medics. We all need to give ourselves permission to take care of ourselves.

As a people pleaser, I have struggled for years to give myself this permission. I thought self care was ‘selfish’, so instead I prioritised other people’s needs. I thought, naively, this was the road to success. It was not. For me, it was the road to poor mental health and proved to be no good for me or those around me. 

It can feel tough to give ourselves permission to take care of ourselves when there is so much need and so many pressures.


Facing huge demands has been a common experience for NHS staff even prior to the pandemic, due to chronic staffing and resourcing issues. We are surrounded by need: clinical need, need to care for our children, elders and neighbours. We can feel pulled in all directions. Many healthcare workers feel guilty if they are not always helping others first.

Workplace Pressures

Doctors are also facing unprecedented workplace pressures, and are feeling the strain. 

Permission to Take Care of Ourselves

A BMA survey of more than 16,000 frontline doctors conducted to April 30th 2020 reports around a third (just under 30 per cent) now have worse mental health than before the pandemic. 

Some of us are working in unfamiliar ways or facing the personal risk of contracting Covid 19, a risk few of us anticipated when we applied to med school. Some are worried about bringing the virus home to loved ones. Others are separated from family in an effort to shield them, and are living with loneliness while still doing emotionally draining work. Many have witnessed tragedy, trauma and loss. And there is anger about some issues, in particular PPE (Personal Protective Equipment) provision.

Despite, or maybe because of all this, permission to take care of ourselves remains critical to surviving mentally intact.

Resourcing Ourselves

This pandemic is a marathon, not a sprint. We need to resource ourselves so we are well enough to take care of ourselves and those around us at work and at home, in a sustainable fashion. 

Resourcing takes a variety of forms. 

A key first step is to ask yourself, what do I need right now? And if possible, do this thing. It can be the small things that we can all hopefully squeeze into the busiest of shifts; a cup of tea with a colleague, a kind word. 

It is helpful to actually do those things we tell our patients to do; getting exercise and good sleep, eating a balanced diet and so forth. Mindfulness has a strong evidence base and is suitable for many, though not all. I’d recommend taking a look at the Oxford Mindfulness Centre or Headspace.

Of course for us all, it is important to discuss with our GP if we are struggling and to avoid attempts at ‘Physician heal thyself’.

When we are ready, reflecting on and sharing how we are really feeling can help us process our experience.

Individuals vary in the best way to reflect, so it can help to try a few strategies and see what ‘fits best’. Some find creative pursuits or journaling help, others prefer to discuss with loved ones. Debriefing with the team can help some people, as you have been through shared experience, although this  depends on your team culture. It is important to notice when you are ready to reflect and to find an approach that feels safe for you. All these strategies are valuable, and there are great support resources out there, but without permission, we won’t allow ourselves to access any of them.

Permission to Take Care of Ourselves

The aeroplane analogy is really relevant here – it really does help to put on your own oxygen mask first, before helping others.

The Modern Hippocratic Oath

I have found the recent addition to the Declaration of Geneva 2017 (the modern Hippocratic Oath) helpful too:

 … I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard..

This was only added 3 years ago, which in itself illustrates another point. We have been slow to recognise the importance of permission to take care of ourselves. 

However, it is there now, at last, in black and white.

I hope it may help you to put on your oxygen mask first.

Further Reading

Also Human – Caroline Elton

Caroline is a psychologist who specialises in helping doctors. Here she describes stories of some doctor’s lives and struggles; a timely reminder that doctors are also human.

Breaking and Mending – Joanna Cannon

A powerful memoir of Joanna’s story as a junior doctor.

Permission to Feel: Unlocking the power of emotions to help our kids, ourselves and our society thrive  – Marc Brackett

Recently published, this is one on my ‘To read list’! Having watched him speak I am interested to read his book and you may be too.

Check out Katya’s Soundbite videos on Instagram:

For more support resources, check out our wellbeing section.

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Katya, aka the Working Well Doctor is a Wellbeing Trainer, Writer & Occupational Health Doctor. Having witnessed many professionals struggle with their wellbeing, she is passionate about encouraging us all to ‘Work Well’ and thrive; to feel well while we function well, both at home and work...…………………………….. DISCLAIMER: This content is as accurate and comprehensive as possible, but it is only general advice and should not be used as a substitute for the individual advice from your own doctor. For doctors, as usual, please use your own clinical judgement when interpreting this information and deciding how best to apply it to the treatment of patients.