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The Cup Analogy and Self-Care

Posted on January 20, 2017

This week is difficult for many of us who are fearful about what a Trump administration means for the future of health care, housing, social services, and many other issues we care deeply about, both personally and professionally. While not strategically planned, this post could not be better-timed. Although we are examining empathetic intensity, we are talking about stress, and, whether the stress comes from our work with clients or worry for our country, it impacts our bodies and minds in similar ways.

Please take care of yourselves, and keep an eye on your cup!

This post continues our examination of dangers associated with work with a client who has experienced trauma or high levels of stress. Last week we discussed empathetic intensity, and how emotions are contagious. It is hard for me to go any further without introducing an analogy I use in nearly every one of my trainings: the cup analogy.

My training content is in constant flux. I’m always integrating new research and approaches to explain complex subjects like the brain, mind, and epigenetics. If you were to look at training I did five years ago, you would notice that it is completely different from the one I did this week in Ft. Worth, Texas. This constant evolution is what I love about being a trainer in the dynamic field of trauma.

While most of my training components have a shelf life of a year before being replaced or revised, the cup analogy is the exception. I run into people that attended one training I did five years ago, and I often hear, “We still talk about cups all the time.” The other feedback I get is that people use the analogy to help clients understand stress and how it impacts thinking and behavior. So while I will use the cup in the context of self-care here, you can use this in your work with clients as well.

The cup analogy begins with the concept of robustness. According to Webster’s Dictionary, “Robustness is defined as having or exhibiting strength or vigorous health and being capable of performing with success or without failure under a wide range of conditions.” One of the primary goals of self-care is to increase robustness, allowing us to bring the necessary energy we need to be successful in our work.

The cup analogy provides a visual to demonstrate the impact of stress, and the continuing impact of past trauma (including secondary and vicarious trauma) on robustness. The cup analogy starts with the size of the cup, or robustness state. The bigger the size of the cup, the more stress you can hold without it negatively impacting your ability to regulate emotions and utilize your cognitive brain.

Factors such as living a healthy life, building self-confidence in one’s skills and abilities, maintaining healthy relationships, age, and maintaining an exercise program over a period of years, increase the cup’s capacity. Conversely, factors such as a poor diet, stress from poverty and financial problems, unresolved trauma, struggles with employment or at school and being in unhealthy relationships decrease capacity. Typically, robustness states stay consistent over time if someone’s life situation remains constant. The exception to this rule is trauma, which reduces capacity quickly and, if healing does not occur, can keep capacity low over long periods.

The next component of this analogy concerns robustness levels. The robustness level is the amount of water in the cup at any given time. The water in the cup represents the amount of stress hormones in your nervous system at the time. The key hormones this represents are cortisol and epinephrine.

Cortisol is a steroid hormone that prepares us for physical action. Throughout human evolution, stressful situations required a physical response, compelling a person to either run away from a predator or fight an enemy. Cortisol shifts the fuel of the brain, oxygen, and glucose (blood sugar), towards muscles and out of the brain, preparing for action. Epinephrine, or adrenaline, is a hormone and neurotransmitter that intensifies the cortisol reaction. Cortisol sets the body up for the reaction and epinephrine reinforces the physical response, diverting more resources away from mental functions, sending them towards your arms and legs to prepare you for action. Epinephrine is not always released when a person feels stressed. As the event becomes increasingly stressful, the brain will need to have a similarly intense response, and the more likely the release of epinephrine.

As a cup fills with these hormones, we start to lose our capacity for cognitive functioning and emotional regulation, as energy goes from the thinking parts of the brain to the emotional and reactive parts. When water reaches the top of the cup, we are in crisis and start operating in full survival mode. When this happens, we lose the ability to engage effectively with the others, to problem solve, and to think strategically about future actions and their consequences.

In the cup analogy, empathetic intensity occurs when we allow a client to pour some of the stress and trauma from their cup into our cup. Many clients’ capacity or cup size decrease in size due to past trauma, poverty, relationship struggles, and other stressors. Also, they have tremendous amount of stress in their present. Much of our job entails helping clients process the stress in their cups and open up their cognitive capacity.

When we do this, we open ourselves up to the pain and suffering of our clients. We have a high level of exposure to traumatic things like child abuse, sexual assault, domestic violence, racism/discrimination, homelessness, terminal disease, and other traumatic events on a daily, if not hourly, basis. While this is what we signed up for by taking our job, it doesn’t mean that we will not be affected by the traumatic realities we face every day.

Self-care is so important because it directly affects our capacity to hold stress, and what we do with stress in our cup. Next week, we will introduce the Window of Tolerance, and examine what happens when empathetic intensity or burnout limit our stress capacity. I want to open the comment section for any thoughts you have on the cup analogy, as it relates to you or your clients’ thinking and behaviors. For those of you who have attended one of my trainings, I would love to hear how you have used this analogy in your work.