PRN: A New Framework for Self-Care

Trauma Recovery Specialist Wants You to Pause, Reset, and Nourish

As the mental health impact of the coronavirus pandemic becomes clear, so too does the need for skills to help people recover psychologically and build resilience for the long term. In a recent workshop at COVID Support VT, trauma specialist Melissa Brymer, Ph.D., Psy.D., advocated a proactive approach to psychological well-being in the Covid era.

Brymer is director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress. She studies how best to offer psychological assistance in the aftermath of disasters and is co-author of Psychological First Aid. 

In spite of its collective nature, Brymer says the Covid experience has unfolded differently for each of us. One common factor is added stress as a result of the pandemic. When it’s repetitive or chronic (as with an ongoing pandemic), stress takes its toll on our health, mentally, emotionally and physically. Finding ways to manage stress and minimize its impact is essential to building the resilience we need to continue to cope with the added burdens of life in a global pandemic.

In other words, self-care is no longer a luxury. It’s a necessity.

Self-Care Now: Pause, Reset, Nourish

Brymer outlined a “new framework for self-care” called PRN, for Pause – Reset – Nourish, from the National Child Traumatic Stress Network. It’s a spin on a common medical instruction known as PRN for a Latin phrase, pro re nata, which means take as needed. (Headache medicine, for example, is usually prescribed PRN.)

Pause – Reset – Nourish applies the concept of “take as needed” to self-care.  The idea is to have a plan in advance that you can go to instantly when you find yourself in a state of mind, body, or emotion that is not serving you. 

Here’s the PRN formula. Take as needed.

Pause

Do the Three-Breath Check-In with your body, mind and feelings:

• Take a breath. Ask: Where do I feel stress in my body? Let it out.
• Take a second breath. Ask: What’s going on in my mind right now? Let it out.
• Take a third breath. Ask: What do I notice about my feelings? Name them. Let it out.

Reset 

Figure out what works for you to reset your mindset from difficult or stressful situations so you can access that tool in the moment you need it. Acknowledge the feeling, and imagine letting it go. Then refocus your attention on something positive, a mantra, an affirmation, gratitude, humor. Think about quick things that you can do – a micro-moment of mindfulness, a moment outside to breathe fresh air, or interacting with a pet. Do what works for you. See resources for finding help in figuring that out.

Nourish

What do you need to nourish yourself right now? How do you replenish mind-body-heart-soul-spirit? If you’re stuck for answers, name a rewarding or meaningful moment at home or work. Something you did that made you feel great. Where can you find moments in your day to be playful, lighthearted, joyful? Create your own affirmation or mantra to repeat to yourself in times of stress. 

Five Principles for Community Self-Care

Brymer laid out five core principles she and colleagues have identified as central to communities’ collective psychological recovery in an ongoing pandemic.

Safety. Recognize that the pandemic has not been the same for everyone. For a significant proportion of the population, Brymer said safety has been and remains a concern. Suicide among youth has risen sharply. Increased incidence of child abuse and interpersonal violence, racism, and discrimination pose acute or chronic safety risks and demand our attention. 

Calming. What coping strategies do we have to calm ourselves when we experience disruptions to how we’re feeling? We may need different coping strategies for different scenarios, at different times, Brymer said. What works for us now may be different than what was working for us before. 

Self-efficacy. “We all have strengths – communities, families, individuals. How do we make sure that we tap into each of our strengths?” Brymer said it’s important to acknowledge what we’ve been through, even “just celebrating being with one another.” Projects, resources, and support networks that allow people who are most impacted to be part of the solution will build community resilience.

Connectedness. Social connectedness is so important in these isolating times, and reconnecting “isn’t happening by itself,” Brymer said. “It may take more effort to get people together in safe ways. How can we support those in our community?” For all of us, she suggests setting limits around how to re-engage safely. Allow opportunities to make that happen. She emphasized quality over quantity: healthy connections are key. If our relationships aren’t serving us, ask: “Are there things we can do to make them healthy again? Or do we need to take some time to redirect our energy toward others?”

“Spread out who you get support from. Think about others you can reach out to.”

~ Melissa Brymer, Ph.D., trauma specialist, UCLA/Duke National Center for Child Traumatic Stress

Hope. In the face of prolonged difficulty, holding hope is essential to psychological recovery, Brymer said. “This has been difficult! We need to think through how to support ourselves along the way. How have you remained hopeful in the past? What are the things that we can control? What things can we do to enhance our hope and our family’s hope?”

Learn More and Find Self-Care Resources

Join the next workshop with Melissa Brymer at COVID Support VT,  “Skills for Psychological Recovery: Secondary Trauma and Strengthening our Workforce.” Learn more and register here. 

Watch the recording of the Skills for Psychological Training workshop facilitated by Melissa Brymer.

Learn more about Pause – Reset – Nourish from the National Child Traumatic Stress Network, and its use in workplaces.

Find Self-Care Tips and Resources at COVIDSupportVT.org.

Get the basics on stress – what causes it, what it looks like, and what to do about it. 

Download our Daily Stress Management Plan and print it out at home as a guide to staying on track with your self-care and wellness.

Join one of our daily workshops and support groups on a range of self-care and wellness topics. All are offered virtually (Zoom link provided upon registration) and are free and open to all. Find them here. 

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Blog written by Brenda Patoine on behalf of VCN/Vermont Care Partners for COVID Support Vermont, a grant funded by FEMA and the Vermont Department of Mental Health

Need to Talk?

Call 2-1-1 (in Vermont) for assistance.

In Crisis? 

If you or someone you care for is experiencing thoughts of suicide or self-harm, you can: call the National Suicide Prevention Hotline at 1-800-273-825; text VT to 741741 to connect with a Crisis Counselor 24/7; connect with your local community mental health center for 24/7 support. 

Find Help

Find resources and tools for coping with stress at www.COVIDSupportVT.org.

One-click translation to 100 languages of most everything on the COVIDSupportVT.org website, plus Multilingual Resources.

Find your local community mental health center by visiting Vermont Care Partners.

COVID Support VT is funded by the Substance Abuse and Mental Health Services Administration and Federal Emergency Management Agency, managed by Vermont’s Department of Mental Health, and administered by Vermont Care Partners, a statewide network of 16 non-profit community-based agencies providing mental health, substance use, and intellectual and developmental disability services and supports.