Here’s a scenario from my clinical practice as a psychiatrist specializing in women’s mental health that happens often: A patient laments that she finally worked up the nerve to take the afternoon off work, only to spend the whole afternoon feeling guilty about her leftover to-do-list, and the emails that went unanswered. She even scheduled herself a “treat yourself” massage, but spent the whole massage ruminating on how she would have to make up for her lost productivity tomorrow.
Sound familiar? I’m a board-certified psychiatrist and the founder and CEO of the women’s mental health community, Gemma, and these are the types of problems I hear about all of the time.
We all know that wellness is broken – a bubble bath and a glass of wine are not going to fix the huge social problems that we are all facing globally – whether that is income inequity, climate change, or how because of a global pandemic, women have been set back decades in terms of gender progress.
In my new book REAL SELF-CARE, I propose a solution. Self-care is not a product to buy or even a task to check off the list. Real self-care is an internal decision-making process. It’s about how we choose to spend our time and our energy. It’s something we embody, not something to accomplish. Real self-care is a verb, not a noun.
Important reminders to recharge your batteries
Take my patient Shalini – she knew that going for a weekly swim was profoundly nourishing for her, physically and mentally. So, she reorganized her entire work schedule and lifestyle so that she could make it to the pool 2 times a week. The commodified, consumeristic version of self-care (what I identify as Faux Self-Care) would say that swimming was self-care.
I’m proposing something more radical. For Shalini, real self-care was the internal decision-making work she did to identify that swimming was important to her, the boundaries she set with her partner and work so she could get to the pool every week, the compassion to gave to herself, and the cognitive work she did to build her schedule this way. The decision-making process, which was aligned with her values, and unique to Shalini’s circumstances, was real self-care.
What I’m talking about here is the distinction between methods and principles. Methods are operational, they work for a circumscribed situation. Principles, however, are universal and take into account perspective. In my conceptualization of real self-care, I use this framework because I find that in my clinical practice and at Gemma, many women notice that the self-care methods that worked in their 20s or early 30s, no longer hold up later in life, when they have less discretionary time due to raising a family or career pressures.
Instead of thinking of self-care as something discrete that you accomplish, and check off a list, I’m redefining it to be threaded inside every decision that we make. Real self-care is an internal decision-making process that can be layered into everything you do.
Proven to put a smile back on your face*
And here’s why this is so critical. I’ve written before about how burnout is a symptom of social betrayal, and that instead of placing the burden on individuals to “be well,” we need to be fixing the root cause of our problems – the collective social systems that cause us to feel fatigued and hopeless in the first place.
Swimming twice a week does nothing to fix white supremacy or rising income inequities. But, as a psychiatrist, I have seen that personal change and collective action are inherently connected.
Both must happen simultaneously and feed off of each other. When a critical mass of us values our time and our energy differently, that’s when social change happens. For example, through real self-care, another patient in my practice was able to initiate a funded support group in her workplace for people struggling with mental health conditions. She did not set out with the goal to be an advocate, no. Her goal was simply to heal internally, and to feel better. The process of real self-care accomplished that, and also had cascade effects which caused social change in her workplace.
This is the power of real self-care: when one person thinks and acts differently, they motivate others to think about their lives differently.
As the iconic Audre Lorde said, “your power is relative, but it is real. And if you do not learn to use it, it will be used against you, and me, and our children. Change did not begin with you, and it will not end with you, but what you do with your life is an absolutely vital piece of that chain.”
Dr. Pooja Lakshmin MD is a psychiatrist, a clinical assistant professor at George Washington University School of Medicine, and the founder and CEO of Gemma, the women’s mental health platform centering equity.
She is the author of REAL SELF-CARE: Powerful Practices to Nourish Yourself from the Inside Out (Cornerstone Press, Feb 23 2023).
