American Association for Physician Leadership

Self-Management

A Self-Care Checklist for Leaders

Palena Neale, PhD

December 1, 2024


Summary:

This five-part checklist can help leaders make self-care a reality, including strategies such as making a body budget, managing emotional health, identifying choice points, and prioritizing growth and nourishment. Leaders are encouraged to personalize their plan and practice regularly for optimal health and effectiveness as a leader.





Despite the momentous rise in media attention given to care, resilience, and well-being since the pandemic began, many leaders struggle to implement self-care practices. We know — from research, experience, and anecdotal evidence — that we need to care for ourselves for optimal functioning and to become healthier and more efficient leaders, but putting this into practice is another story. Recently, I delivered a week-long leadership training to 30 education leaders from 21 different countries. When asked, not one of the leaders had a regular self-care practice. I see the same trend among my leadership clientele — also from many different backgrounds, locations, and industries — who continue to find self-care a challenge.

There are many reasons, personal and structural, why some leaders struggle to prioritize care for themselves. The emotional labor of leadership alone consumes energy. And we all come to self-care with our own perspectives and challenges based on our personalities, experiences, socialization, and family contexts. One client revealed that it’s “normal” for him to worry about his staff’s health but not his own; another shared that time for herself is considered “indulgent and lazy” by her extended family. Cultural, societal, and organizational factors also influence how leaders engage with self-care, from “we don’t do this in our culture” to organizational cultures that value what one client calls “strength and heroism” over self-care. Leaders also cite a lack of time and knowledge of what to do as barriers affecting their engagement with self-care.

So, how can we integrate self-care as part of embracing and modeling resilient and sustainable leadership? Changing behavior starts with changing your mindset. Then, you can adopt tactical strategies to put these ideas into practice.

Set Yourself Up For Success

Before you get started, prepare for success by adopting a mindset that lets you:

Give yourself permission to extend care and empathy inward.

If you don’t currently tend to yourself, ask yourself, “why?” What stops you from caring for yourself? Whatever your reason, weigh this against the importance of good health for optimal human functioning. Give yourself whatever permission you need to practice and model what healthy leadership looks like for you in your organization.

Meet yourself where you are.

If this feels foreign or “woo-woo,” build on what you already have in place. Use your annual physical to review your health, identify diet and exercise improvements for when you travel, or use the next team meeting to identify areas where you can ask for help and support from others.

Avoid all-or-nothing thinking.

You won’t move from zero self-care to embracing everything perfectly. This is a dynamic process, offering moments of success and failure, which is normal. When you miss a day of exercise or have no sleep because of a deadline, you can recalibrate the next day.

Take a page from colleagues.

Many of my clients observe (with awe and frustration) other people’s willingness to prioritize self-care by claiming boundaries and taking time off, including mental health days. Take a page from their playbook. Borrow other care ideas that could work for you.

Prioritize small and steady.

Identify one or two small changes you can make this week and commit to implementing them on a regular basis. For behavior change, consistency is key. For example, take the stairs at work or listen to your favorite music during some or all of your lunch instead of working through it.

Find an accountability buddy.

If you’d like to prioritize some growth time but have trouble (maybe you feel like you’re “slacking” after your 80-hour work week!), identify a trusted colleague or family member to remind you to take an hour Friday afternoon for some reflection or to learn something new.

Celebrate and savor.

Congratulate yourself for any efforts you make. Think about how you can extend or savor these moments of creation, satisfaction, or connection a little bit longer before you jump to the next thing on your to-do list.

Your Checklist

Now that you have prepared your mindset, here’s a simple checklist that covers five key components of your self-care: caring for your body, mind, relationships, capacity for choice, and growth. I have used this with hundreds of leaders.

Take 15 minutes once a week to reflect on your health in each of these five areas, noting what’s been working for you and where you may need to dial up or down to improve.

1. Body budget

Drawing on what professor of psychology Lisa Feldman Barrett refers to as body budgeting, your brain is always predicting your body’s energy needs, determining what is required to keep you alive and flourishing, by calling on past experiences as a guide. You expend energy when you move your body, you replenish it when you eat, drink, and sleep, and you reduce your “spending” when you relax. Other things that affect your energy and the quality of your life that day could be unexpected events, a particularly heavy workload, or times of stress.

Consider that you have a budget of energy that is affected by diet, stress, exercise, and sleep. Give yourself a score out of 5 for your exercise, sleep, and eating habits — at home and on the road — and then look at ways to improve your score. For example, if you travel non-stop, don’t exercise, skip meals on the road, and miss sleep, you might score yourself 1 for exercise, diet, and sleep and look at how you can raise your scores the following week.

Here are some of my favorite leader-tested tips for balancing your body budget on the job:

  • Reduce the number of late-night/early-morning Zoom meetings you take or limit international travel until you are sufficiently replenished. This is also a great opportunity to delegate travel to a colleague if possible.

  • Invest in pre-travel meal-planning (or restaurant plans) to make healthy choices whether you are at home, in the office, or on the road. Pay attention to hydration and never leave home without your water bottle.

  • Incorporate micro-workouts. Clients have reported using apps to do 15-minute HIIT or pilates sessions in their offices, walking the stairs in their building several times throughout the day, or using the coffee or water stations on another floor to increase movement throughout the day. Hire a personal trainer, walk to meetings when you can, or schedule exercise in your calendar.

  • When going on the road, plan exercise into your day. Check if your hotel has a gym (stairs are also great), sign up for local fitness/yoga/dance classes in advance, use your favorite workout app, or try a YouTube workout.

  • Practice mindful or no alcohol consumption on the road from airport lounges to client dinners. For one of my clients, this means drinking one glass of water for every glass of alcohol consumed.

My clients consistently report that investing in their diet, exercise, and sleep (however difficult) brings positive mental and physical rewards and improves their mood and functioning at work. It is also an excellent way to model what healthy leadership care looks like for others.

2. Emotional health

My client work has highlighted two main areas that significantly influence leaders’ emotional health: the ability to regulate emotions and the ability to relax.

Many of the leaders I work with come to coaching with a strong emotion about something, like “X insisted on taking her weekend off in the middle of a PR crisis and I am furious.” These emotions are high in energy consumption and often accompany us home if we don’t have strategies for managing them. I use a simple ABC framework to help leaders process strong emotions:

  • A – Awareness. What happens when you feel big or strong emotions? What do you think, feel, and do? Are you able to call on your best and most creative thinking and problem-solving in this state?

  • B – Build your intelligence base. Dig deeper. What’s sitting underneath this big emotion? Think: “How can I be more precise about what I am feeling, or what I’ve observed in others, to gain a more accurate view of what is going on?” For the furious manager, further exploration showed that they felt a sense of deep frustration toward their staff member who wasn’t around in a crisis. Frustration is a different emotion than fury, and in their case, their frustration indicated a need to communicate differently with a new staff member.

  • C – Communicate. What conversation do you want/need to have? And with whom? I often find that more than one conversation is required: the one necessary to have with someone (e.g. a direct report not available during a crisis) and the conversation to have with themselves about their own role in it (e.g. acquiescing and seething in silence). How would they like to handle it in future?

Another important component of well-being is the ability to relax. Some of my clients report that they can’t remember the last time they felt relaxed. Research tells us that time in nature, human touch, stroking your pet, and gratitude practices are great for relaxation. My clients have reported that wrestling with their kids, watching YouTube videos on quantum mechanics, or preparing a family barbeque are their ways to relax, allowing them to return to work recharged and refreshed.

If anything relaxing feels foreign to you, start by asking yourself what “relaxed” means for you, and imagine what it might look and feel like if you approached the new work week or an upcoming board meeting presentation in a relaxed manner.

The “furious” leader who actively explored what was underneath was able to label their frustration and identify some pathways for dealing with this as part of effectively managing their emotions. Leaders able to identify and practice ways to relax can better cope with stress, maintaining a balanced body budget.

3. Relationships and collaboration

Think about your relationships with others — how you give and receive support, collaborate, and role-model. Science tells us that our brains collaborate with other brains. This collaboration influences our neurons’ tuning process and strengthens certain neural connections to regulate our bodily functions with others’ (e.g. matching breathing and heartbeat). It also impacts our energy budgets and well-being.

We are a social species, and leading is all about relationships and community, making it even more important to role-model positive relationships and collaborate with intention.

I recently spoke with a leader in the tech industry who told me that whenever jaded team members join yet another online meeting, one colleague always gives an extremely enthusiastic “HELLO!” The mood and tone of the meeting immediately changes to a positive and enthusiastic one — every time.

Think:

  • What kind of collaboration do you want to model as a leader? How can you facilitate that?

  • What kind of relationship support do you want/need? (E.g. a coach, therapist, mentor, challenge network, support circle, etc.)

  • Which relationships do you want/need to let go of?

  • How do you want to connect with loved ones?

While a raucous “hello” won’t solve all your leadership challenges, it reminds us that emotions are contagious, and that we can bring more intention to being in relationship and collaboration. Intention also extends to regularly reviewing our relationships to determine which are working, which are not, and what support is required to deliver your mandate and manage your energy.

4. Choice points

The research is clear: As humans we crave autonomy, which implies choice. In fact, one study found that autonomy and choice are key to happiness. We can take control by creating more choice points — moments where we recognize that choice is available to us. This might include choosing whether or not to ask for help, or whether or not to have a difficult conversation. We can further maximize our choices by being intentional about whether our decisions are based on our goals and values. Choice brings into focus our level of comfort with asking for what we want or need, as well as the consequences of action and inaction — ours and others’. We can take control by creating more choice points — moments where we bring in intention and make decisions to move towards our goals or values. Choice brings into focus our level of comfort with asking for what we want or need as well as the consequences of action and inaction — ours and others’.

For example, some leaders I work with cited the following reasons why they struggle to ask for help: their fear of being perceived as vulnerable or weak, not wanting to burden others, people-pleasing, not knowing how to ask, discomfort providing corrective feedback, or time constraints. One of my cloud computing VP clients mentioned how he routinely checks in to ensure that his staff’s body budgets are in balance, yet qualified, “I’ve just never done this for myself.” His choice of action is to take on more work to unburden his staff. A finance CEO says she doesn’t delegate because she can do it quicker herself and “it’s not worth the investment and effort.” Her assumptions about the value of her time investment, and her choice, meant more late nights doing more work.

So, how can leaders create more healthy choice points?

  • Ask yourself: What boundaries would support your well-being at this moment in time? Tip: Experiencing feelings of overwhelm or resentment usually indicates the need for some kind of boundary.

  • Identify three tasks you can delegate to support your time-management and give your direct reports a chance to grow. If you are resistant, lean in and identify what stops you from delegating. For example: Is it a lack of trust in others to deliver, a belief you must do everything yourself, or a lack of trust in yourself to provide the feedback required? Identifying what stops you from choosing to delegate helps you identify where and what you can do to become more skillful.

  • Bring in technology. If time is an issue, conduct a time inventory using either a low-tech method like logging how you spend your time over a week or a time-tracking or productivity app (Toggl, Rescue Time, Time Doctor). This can help you understand how you spend your time, identifying patterns and where a boundary might be helpful for productivity and well-being.

  • Invest in your development. Training, coaching, practice, and utilizing online organization platforms all allow you to get more skillful and comfortable in delegating tasks, tracking progress, and ensuring accountability.

Almost everything involves an element of choice. My exhausted VP client was able to identify some valuable choices for himself: leadership coaching, delegation, and taking time off. Mindfully practicing choice produces more resilient leaders.

5. Growth and nourishment

This is about your self-actualization — whatever feeds you at this point in your life and career. For some of my younger leaders, this is about cordoning off time for parenting, learning, or community mobilization; some of my mid-career clients have reported nourishing activities like singing, college visits, mindfulness, and time with their parents.

Neuroscience tells us that learning improves our brain’s neuroplasticity, reshaping the brain’s structure and developing its functions. Creativity, too, builds neural networks, stimulating and enhancing the brain. Meditation also affects neuroplasticity, improving memory and well-being.

For many of my clients, this area of self-care can both intrigue and alienate. I often hear: “I love the thought of doing x, but how can I possibly find time?” Yet neuroscience demonstrates that these practices make you more emotionally literate and contribute to a balanced body budget.

Here, the concept of “yes and” is incredibly important. Yes, you may feel time-scarce and that this is important for your health and well-being and may contribute to greater efficiencies. So, what if you started small? For one CEO, this meant re-engaging in a new way with writing a novel he’d started years ago but never finished. Instead of only working on it when he had three-hour chunks of time, he committed to four 15-minute bursts throughout the week as a minimum — and if he exceeds this, all the better.

What would it feel like if you allocated time each week to something with no other purpose than to nourish you? For some, that may be learning a new language, taking up golf, learning to cook, painting, building, or a spiritual practice.

Aim to:

  • Fan your flames. What lights you up or feeds your soul? If you are stuck, ask yourself: If you had all the money and status you desired, how would you choose to spend your time?

  • Value your values. Which of your core values needs more attention? Conduct a values clarification exercise to identify your top three values, and review how well you are living in accordance with them. This is a great way to shine light on how you can live a more values-driven life.

Growth and nourishment helps keep our body budget balanced and make us more well-rounded individuals and leaders. For my client, not only did he finish his novel; he also started an employee writing group in his tech startup with standing-room only at their first meeting.

Give yourself permission to practice self-care and remember, there is no one best way to do it. This checklist will help you plan your routine. Customize it and make it your own to create more healthy leadership choices, as well as to nourish and care for yourself. It’s vital for your health and well-being, and it’s the smart leadership thing to do.

Regardless of where you stand on self-care, physiology doesn’t lie: Having a balanced body and mind affects how you live, show up, and ultimately, how you lead.

Copyright 2024 Harvard Business School Publishing Corporation. Distributed by The New York Times Syndicate.

Explore AAPL Membership benefits.

Palena Neale, PhD

Palena Neale, PhD, is the founder of unabridged, a leadership development practice based in Paris that provides coaching, mentoring, and learning interventions to help professionals have greater personal and social impact. She designs and delivers women’s leadership training programs for individuals and organizations globally, including executive leadership courses for the United Nations, government, and private sector. Palena researches and teaches on topics related to women’s leadership.

Interested in sharing leadership insights? Contribute



For over 45 years.

The American Association for Physician Leadership has helped physicians develop their leadership skills through education, career development, thought leadership and community building.

The American Association for Physician Leadership (AAPL) changed its name from the American College of Physician Executives (ACPE) in 2014. We may have changed our name, but we are the same organization that has been serving physician leaders since 1975.

CONTACT US

Mail Processing Address
PO Box 96503 I BMB 97493
Washington, DC 20090-6503

Payment Remittance Address
PO Box 745725
Atlanta, GA 30374-5725
(800) 562-8088
(813) 287-8993 Fax
customerservice@physicianleaders.org

CONNECT WITH US

LOOKING TO ENGAGE YOUR STAFF?

AAPL providers leadership development programs designed to retain valuable team members and improve patient outcomes.

American Association for Physician Leadership®

formerly known as the American College of Physician Executives (ACPE)